OMB control number
COBRA Continuation Coverage: Premium Assistance
OMB 1210-0167 ยท DOL/EBSA.
OMB 1210-0167
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 1210-0NEW- SS_COBRA Premium Assistance 4.6.21.docx | Supporting Statement A |
| COBRA Emergency Clearance Memo to OMB 3-1-2021.docx | Supplementary Document |
 COBRA Notices |
Other-Alternative COBRA subsidy notice |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202103-1210-002 | New collection (Request for a new OMB Control Number) | 2021-04-06 | Approved with change |