Information Collection

Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System

IC 33690 under ICR 202401-3206-001 · OMB 3206-0201.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEHB IVR Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System	Form and Instruction
FEHB_IVR_Scripts_2023.docx	Instruction
FEHB_IVR_Scripts_2023.docx	Other-Scripts
FEHB_IVR_PAS_PBS_2023_Revised.docx	Instruction
FEHB_IVR_PAS_PBS_2023_Revised.docx	Other-Privacy Act and Public Burden
FEHB IVR Open Season Online FEHBOS_IVR_Web Pages 1.pdf	Form and Instruction
FEHB IVR Open Seas Web page 1 FEHBOS_IVR_Web Pages 1.pdf	Form and Instruction
FEHB IVR Open Season Online FEHBOS_IVR_Web Pages 2.pdf	Form and Instruction
FEHB IVR Open Seas Web page 2 FEHBOS_IVR_Web Pages 2.pdf	Form and Instruction
FEHB IVR Open Season Online FEHB_IVR Web page 3.docx	Form and Instruction
FEHB IVR Open Seas Web page 3 FEHB_IVR Web page 3.docx	Form and Instruction
FEHB IVR Open Season Online FEHBOS_IVR_Web pages 4.pdf	Form and Instruction
FEHB IVR Open Seas Web page 4 FEHBOS_IVR_Web pages 4.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR 890

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEHB IVR Open Season Online	Web page 1	FEHBOS_IVR_Web Pages 1.pdf	Yes	Yes	Fillable Printable
Form and Instruction	FEHB IVR Open Season Online	Web page 2	FEHBOS_IVR_Web Pages 2.pdf	Yes	Yes	Fillable Printable
Form and Instruction	FEHB IVR Open Season Online	Web page 3	FEHB_IVR Web page 3.docx	Yes	Yes	Fillable Printable
Other-Scripts			FEHB_IVR_Scripts_2023.docx	No		Paper Only
Other-Privacy Act and Public Burden Statements			FEHB_IVR_PAS_PBS_2023_Revised.docx	Yes	No	Printable Only
Form and Instruction	FEHB IVR Open Season Online	Web page 4	FEHBOS_IVR_Web pages 4.pdf	Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM/Central 1

FR Citation: 73 FR 15013

Number of Respondents: 350,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	350,100	350,100
Annual IC Time Burden (Hours)	58,349	58,349
Annual IC Cost Burden (Dollars)	1,575,450	1,575,450

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.