Information Collection Request
Summary of Benefits and Coverage and Uniform Glossary Required Under the Affordable Care Act
ICR 202503-1210-005 · OMB 1210-0147 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 1210-0147 SBC DOL PRA supporting statement 3-20-25.docx |
Supporting Statement A | Uploaded 2025-03-20 | Repair queued |
| Justification for No Material or Nonsubstantive Change to Currently Approved Collection (OMB Control 1210-0147).docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-01-14 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 198891 |  Modifications |
Modified | ||
| 198890 | Glossary |
Other-Uniform Glossary- November 2019 | Modified | |
| 198888 | Summary of Benefits and Coverage |
Other-SBC Template | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/EBSA |
| OMB Control No | 1210-0147 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202501-1210-003 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |