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Requests for Mailed Disclosures
Transparency in Pricing Information
OMB: 0938-1429
IC ID: 271421
OMB.report
DOL/EBSA
OMB 0938-1429
ICR 202410-1210-001CF
IC 271421
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1429 can be found here:
2024-10-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View RCF Information Collection (IC)
IC Title:
Requests for Mailed Disclosures
Agency IC Tracking Number:
CCIIO - 10715
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
45 CFR 147.210(b)(2)(ii)
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:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
327
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
54 %
Requested
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
21,264
0
0
21,264
0
0
Annual IC Time Burden (Hours)
5,316
0
0
5,316
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.