Employee Benefit Plan Claims Procedure Under the Employee Retirement Income Security Act

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
1210-0053 Claims Procedure 03-01-2023.docx	Supporting Statement A	Uploaded 2023-03-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13352	Employee Benefit Plan Claims Procedure Under ERISA		Modified

ICR Details

OMB Control No: 1210-0053	ICR Reference No: 202301-1210-002
Status: Active	Previous ICR Reference No: 202001-1210-001
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Employee Benefit Plan Claims Procedure Under the Employee Retirement Income Security Act
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/10/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/07/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2026	36 Months From Approved	04/30/2023
Responses	1,436,422,678	0	1,465,526,748
Time Burden (Hours)	28,981,362	0	1,627,422
Cost Burden (Dollars)	262,290,654	0	1,959,351,534

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Abstract: In November 2000, the Department issued a final regulation establishing minimum claims procedure requirements that all employee benefit plans under ERISA must meet in order to satisfy the requirements of section 503 of ERISA. Section 505 of ERISA authorizes the Secretary to prescribe regulations as appropriate or necessary to carry out the provisions of Title I of ERISA. The regulation requires plans to provide every claimant who is denied a claim with a written or electronic notice that contains the specific reasons for denial, a reference to the relevant plan provisions on which the denial is based, a description of any additional information necessary to perfect the claim, and a description of steps to be taken if the participant or beneficiary wishes to appeal the denial. The regulation also requires that any adverse decision upon review be in writing (including electronic means) and include specific reasons for the decision, as well as references to relevant plan provisions. The information collection requirements included in the claims procedure regulation ensure that participants and beneficiaries (claimants) receive adequate information regarding the plan's claims procedures and the plan's handling of specific benefit claims. The Department has received approval from OMB for this ICR under OMB Control No. 1210-0053. The current approval is scheduled to expire on April 30, 2023.

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Authorizing Statute(s): US Code: 29 USC 1133 Name of Law: Employee Retirement Income Security Act of 1974
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 43897	07/22/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 14179	03/07/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Employee Benefit Plan Claims Procedure Under ERISA

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	1,436,422,678	1,465,526,748	0	0	-29,104,070	0
Annual Time Burden (Hours)	28,981,362	1,627,422	0	0	27,353,940	0
Annual Cost Burden (Dollars)	262,290,654	1,959,351,534	0	0	-1,697,060,880	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: No program changes have been made since the previous submission. This information collection uses updated wages, mailing costs, and updated data inputs. The number of responses has decreased by 29,104,070. The number of respondents has decreased by 2,915,980. The decrease in the number of respondents is attributed to a change in the estimate of the number of disability plans. The previous estimate double counted plans that provided both disability and health benefits. Plans that offer both health and disability are now only counted in the health plan counts. Additionally, the burden of the third-party service provider has been shifted from cost burden to hour burden. Previously, the 95 percent of the burden estimated to be handled by an outside service provider was accounted for as cost burden. These changes have increased the hour burden and decreased the cost burden. The hour burden has increased by 27,353,940 hours and the cost burden has decreased by $1,697,060,880.

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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]? No

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

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Common Form ICR:  No

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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: 03/07/2023

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