Information Collection

Group Health Plans Internal Claims and Appeals and External Review Processes

IC 193852 under ICR 202301-1545-016 · OMB 1545-2182.

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Documents and Forms

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IC Title:

Group Health Plans Internal Claims and Appeals and External Review Processes

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2560.503-1 29 CFR 2590.715-2719

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,007,298

Number of Respondents for Small Entity: 1,746,349

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 58 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	314,560	159,395	155,165
Annual IC Time Burden (Hours)	14,432	14,083	349
Annual IC Cost Burden (Dollars)	571,599	-178,938	750,537

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.