Information Collection Request

Affordable Care Act Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier Disclosure

ICR 202203-1210-001 · OMB 1210-0140 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
1210-0140 ss 3-21-22 OCIO Comment 3.28.22.docx Supporting Statement A Uploaded 2022-03-28 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
195225 Grandfathered Plan Change in Carrier Disclosure Modified
193127 Grandfathered Plan Disclosure and Recordkeeping Requirement Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 05/31/2022
8,868,468 10,770,984
655 1,183
125,533 204,654





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Grandfathered Plan Change in Carrier Disclosure
Grandfathered Plan Disclosure and Recordkeeping Requirement

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 8,868,468 10,770,984 0 0 -1,902,516 0
Annual Time Burden (Hours) 655 1,183 0 0 -528 0
Annual Cost Burden (Dollars) 125,533 204,654 0 0 -79,121 0


Reginfo record details
  No