OMB
.report
Search
Grandfathered Plan Change in Carrier Disclosure
Grandfathered Group Health Plans and Grandfathered Group Health Insurance Coverage
OMB: 1545-2178
IC ID: 263884
OMB.report
TREAS/IRS
OMB 1545-2178
ICR 202312-1545-010
IC 263884
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Grandfathered Plan Change in Carrier Disclosure
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
26 CFR 54.9831
29 CFR 2590.732
26 CFR 54.9815-1251T
45 CFR 146.145
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Taxation Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
39,311
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
38 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
39,311
0
0
39,311
0
0
Annual IC Time Burden (Hours)
655
0
0
655
0
0
Annual IC Cost Burden (Dollars)
125,533
0
0
125,533
0
0
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.