Information Collection

OPM Healthcare and Insurance Customer Experience Feedback

IC 260726 under ICR 202306-3206-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3206-NEW OPM Healthcare and Insurance Customer Experience Feedback	Form and Instruction
3206-NEW Survey Questions- OPM Healthcare and Insurance Customer Survey Questions 5-23-23.docx	Form and Instruction
3206-NEW Survey Questions- OPM Healthcare and Insurance Customer Survey Questions 5-23-23.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	3206-NEW	Survey Questions- OPM Healthcare and Insurance Customer Experience Feedback	Survey Questions 5-23-23.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 360,000

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360,000	360,000
Annual IC Time Burden (Hours)	18,000	18,000
Annual IC Cost Burden (Dollars)	343,980	343,980

Documents for IC

table that charts IC Documents
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.