EBSA Participant Assistance Program Customer Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Justification for No Material or Nonsubstantive Change to Currently Approved Collection (OMB Control 1210-0161)_2.25.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-25	Available
Justification for No Material or Nonsubstantive Change to Currently Approved Collection (OMB Control 1210-0161)_2.25.25.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-25	Repair queued
1210-0161 2024 PAP Satisfaction Survey - Part A and B 9-11-24.docx	Supporting Statement B	Uploaded 2024-10-10	Available
1210-0161 2024 PAP Satisfaction Survey - Part A and B 9-11-24.docx	Supporting Statement B	Uploaded 2024-10-10	Repair queued
1210-0161 2024 PAP Satisfaction Survey - Part A and B 9-11-24.docx	Supporting Statement A	Uploaded 2024-10-10	Available
1210-0161 2024 PAP Satisfaction Survey - Part A and B 9-11-24.docx	Supporting Statement A	Uploaded 2024-10-10	Repair queued
GPRA Resources - DOL website.pdf	Supplementary Document	Uploaded 2021-09-30	Available
GPRA Resources - DOL website.pdf	Supplementary Document	Uploaded 2021-09-30	Repair queued
PUBLIC LAW 111–352 -GPRA Modernization Act of 2010.pdf	Supplementary Document	Uploaded 2021-09-30	Available
PUBLIC LAW 111–352 -GPRA Modernization Act of 2010.pdf	Supplementary Document	Uploaded 2021-09-30	Repair queued
Public Law 103-62 - GPRA.pdf	Supplementary Document	Uploaded 2021-09-30	Available
Public Law 103-62 - GPRA.pdf	Supplementary Document	Uploaded 2021-09-30	Repair queued
signed_PRA Signature Form_EBSA_(2021_0928).pdf	Supplementary Document	Uploaded 2021-09-29	Available
signed_PRA Signature Form_EBSA_(2021_0928).pdf	Supplementary Document	Uploaded 2021-09-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238857	EBSA Participant Assistance Program Customer Survey	Other-Survey Instrument	Modified

ICR Details

OMB Control No: 1210-0161	ICR Reference No: 202502-1210-006
Status: Active	Previous ICR Reference No: 202408-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: EBSA Participant Assistance Program Customer Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/27/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/24/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2027	12/31/2027	12/31/2027
Responses	14,081	0	14,081
Time Burden (Hours)	2,347	0	2,347
Cost Burden (Dollars)	0	0	0

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Abstract: EBSA conducts the surveys to evaluate the Participant Assistance Program (PAP) provided by the benefits advisor staff nationwide to understand how well the Agency is meeting service delivery goals by; (1) assessing EBSA's customers' perception of the services provided by the EBSA benefit advisors, and (2) determining what actions the performance data indicate could enable each regional office to provide the best possible participant assistance service; and (3) establishing a current baseline for EBSA's (Government Performance and Accountability Act GPRA) measurement. EBSA will use the data from the survey to track the agency's progress on accomplishing it's GPRA measurement goal. The PAP Customer Survey collects customer satisfaction data for a sample of private citizens who call into the participant assistance program to ask about their private sector employer provided benefits such as pensions, retirement savings, and health benefits. Three types of callers are queried: (1) those who need benefit claim assistance, (2) those who have a valid benefit claim, and (3) those who have an invalid benefit claim will be queried. The results of the survey will be analyzed to provide actionable data that could be used to improve program performance. The study includes data from the EBSA regional offices in Atlanta, Boston, Chicago, Cincinnati, Dallas, Kansas City, Los Angeles, New York, Philadelphia, and San Francisco, as well as the District offices in Miami, Seattle, and Washington.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: EO: EO 13985 Name/Subject of EO: Advancing Racial Equity and Support for Underserved Communities Through the Federal Government

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 7732	02/05/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 84399	10/22/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
EBSA Participant Assistance Program Customer Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	14,081	14,081	0	0	0	0
Annual Time Burden (Hours)	2,347	2,347	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $738,054

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/24/2025

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