Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
1210-0149 FLSA18B Notice SS 8-06-2026.docx	Supporting Statement A	Uploaded 2026-08-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
225307	Notice to Employees of Coverage Options Under FLSA Section 18B (State and Local Gov't)	Other-Model Notice	Modified
206431	Notice to Employees of Coverage Options Under FLSA 18B (Private Sector)	Other-Model Notice	Modified

ICR Details

OMB Control No: 1210-0149	ICR Reference No: 202606-1210-004
Status: Received in OIRA	Previous ICR Reference No: 202301-1210-003
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/16/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2026
Responses	33,688,484	31,595,244
Time Burden (Hours)	280,738	263,294
Cost Burden (Dollars)	12,362,326	5,480,827

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Abstract: Since January 1, 2014, individuals and employees of small businesses have had access to affordable coverage through a competitive private health insurance market—Health Insurance Marketplace. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. Section 1512 of the Affordable Care Act created a new Fair Labor Standards Act (FLSA) section 18B [29 U.S.C. 218b] requiring a notice to employees of coverage options available through the Marketplace. Section 18B of the FLSA, as added by section 1512 of the Affordable Care Act, generally provides that, in accordance with regulations promulgated by the Secretary of Labor, an applicable employer must provide each employee at the time of hiring a written notice: (1) Informing the employee of the existence of the Marketplace (referred to in the statute as the Exchange) including a description of the services provided by the Marketplace, and the manner in which the employee may contact the Marketplace to request assistance; (2) If the employer plan's share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, then the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code (the Code) if the employee purchases a qualified health plan through the Marketplace; and (3) If the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

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Authorizing Statute(s): US Code: 29 USC 218a Name of Law: Fair Labor Standards Act (FLSA)
  

Citations for New Statutory Requirements: None

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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:
	91 FR 7528	02/18/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 65787	10/16/2026
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Notice to Employees of Coverage Options Under FLSA 18B (Private Sector)
Notice to Employees of Coverage Options Under FLSA Section 18B (State and Local Gov't)

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	33,688,484	31,595,244	0	0	2,093,240	0
Annual Time Burden (Hours)	280,738	263,294	0	0	17,444	0
Annual Cost Burden (Dollars)	12,362,326	5,480,827	0	0	6,881,499	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: There are no program changes for this submission, but data was updated. The number of employers and employees has been updated. Wages, postage costs, the rate of new hires, and electronic disclosure rates were also updated. As a result, the number of respondents increased by 2,093,240, the number of responses decreased by 17,444, and the cost burden increased by $6,881,449.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? Yes

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: 10/16/2026

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