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

Forms and Documents

Document Name	Status
1210-0140 ss 3-21-22 OCIO Comment 3.28.22.docx Supporting Statement A	2022-03-28

IC Document Collections

IC ID	Document Title	Status
195225	Grandfathered Plan Change in Carrier Disclosure	Modified
193127	Grandfathered Plan Disclosure and Recordkeeping Requirement	Modified

ICR Details

OMB Control No: 1210-0140	ICR Reference No: 202203-1210-001
Status: Received in OIRA	Previous ICR Reference No: 201902-1210-003
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Affordable Care Act Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier Disclosure
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/07/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	05/31/2022
Responses	8,868,468	10,770,984
Time Burden (Hours)	655	1,183
Cost Burden (Dollars)	125,533	204,654

---

Abstract: The Patient Protection and Affordable Care Act, Public Law 111-148, (the Affordable Care Act) was enacted by President Obama on March 23, 2010. Section 1251 of the Act provides that certain plans and health insurance coverage in existence as of March 23, 2010, known as grandfathered health plans, are not required to comply with certain statutory provisions in the Act. The final regulations implementing the grandfathered plan provision of the Affordable Care Act (29 CFR 2590.715-1251(a)(2)) requires a grandfathered health plan to include a statement in any plan material provided to participants or beneficiaries stating the plan's intent to be a grandfathered health plan within the meaning of §1251 of the Act. To maintain its status as a grandfathered health plan, the final regulations (29 CFR 2590.715-1251(a)(3)) require the plan or issuer to maintain records documenting the terms of the plan or health insurance coverage in effect on March 23, 2010, and any other documents that are necessary to verify, explain or clarify status as a grandfathered health plan. The plan or issuer must make such records available for examination upon request by participants, beneficiaries, individual policy subscribers, or a State or Federal agency official.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 1251 Name of Law: The Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 70866	12/13/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 20470	04/07/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Grandfathered Plan Change in Carrier Disclosure
Grandfathered Plan Disclosure and Recordkeeping Requirement

---

ICR Summary 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

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This ICR contains no program changes. Adjustments to the burden estimates result from updated estimates on the number of grandfathered group health plans and increases in wage and postage rates. These updated data inputs reduce the hour burden by 528 hours compared with the prior submission and reduce the cost burden by $79,121 compared with the prior submission.

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/07/2022

---