Information Collection

Glossary

IC 198890 under ICR 202503-1210-005 · OMB 1210-0147.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
sbc-uniform-glossary-of-coverage-and-medical-terms-new.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits	Other-Uniform Glossary- November 201
sbc-uniform-glossary-of-coverage-and-medical-terms-new.pdf www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits	Other-Uniform Glossary- November 201

IC Title:

Glossary

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2590.715-2715

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
Other-Uniform Glossary- November 2019				https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/summary-of-benefits	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,506,660

Number of Respondents for Small Entity: 2,199,660

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 58 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,569,242	-58,516	1,627,758
Annual IC Time Burden (Hours)	13,077	-488	13,565
Annual IC Cost Burden (Dollars)	808,160	173,334	634,826

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.

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