Information Collection

Grandfathered Plan Change in Carrier Disclosure

IC 263884 under ICR 202312-1545-010 · OMB 1545-2178.

Documents and Forms

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Document Name	Document Type

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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:

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: 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 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	39,311	39,311
Annual IC Time Burden (Hours)	655	655
Annual IC Cost Burden (Dollars)	125,533	125,533

Documents for IC

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