OMB control number
Notice of Pre-Existing Condition Exclusion Under Group Health Plans
OMB 1210-0102 ยท DOL/EBSA.
OMB 1210-0102
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 HIPAA 1210-0102ss12.doc | Supporting Statement A |
 Individual Notice of Preexisting Condition Exclusion under Group Health Plans |
Information collection |
| General Notice of Pre-Existing Condition Exclusion Under Group Health Plans |
Information collection |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201211-1210-003 | Extension without change of a currently approved collection | 2012-12-26 | Approved without change | |
| 200911-1210-002 | Extension without change of a currently approved collection | 2009-12-01 | Approved without change | |
| 200608-1210-002 | Extension without change of a currently approved collection | 2006-10-16 | Approved without change | |
| 200412-1210-001 | No material or nonsubstantive change to a currently approved collection | 2004-12-30 | Approved without change | |
| 200306-1210-008 | Extension without change of a currently approved collection | 2003-06-27 | Approved without change | |
| 200003-1210-003 | Extension without change of a currently approved collection | 2000-03-30 | Approved without change | |
| 199801-1210-001 | Extension without change of a currently approved collection | 1998-01-02 | Approved without change | |
| 199704-1210-003 | New collection (Request for a new OMB Control Number) | 1997-04-08 | Approved without change |