Fed Vip (benefeds.com

Federal Employees Dental and Vision Insurance Program (FEDVIP)

Documents and Forms

Document Name Document Type
Form BF1 FED VIP (BENEFEDS.COM Form and Instruction
BF1 BeneFeds (508) ICR_SCREENS_10312022 (1).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	FED VIP (BENEFEDS.COM	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR Chapter 89A 5 CFR Chapter 89B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BF1	BeneFeds	(508) ICR_SCREENS_10312022 (1).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: OPM/Central-1 Civil Service Retirement and Insurance Records	FR Citation: 82 FR 32191

Number of Respondents: 388,261	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	388,261	388,261
Annual IC Time Burden (Hours)	47,018	47,018
Annual IC Cost Burden (Dollars)	925,314	925,314

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.