OMB control number
Application Requirements to Receive VA Dental Insurance Plan Benefits under 38 CFR 17.169
OMB 2900-0789 ยท VA.
OMB 2900-0789
Section 510 of title III of the Caregivers and Veterans Omnibus Health Services Act of 2010 (section 510) requires VA to establish a new program to offer private, premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Section 510 requires VA to contract with a private insurer (using the Federal contracting process) to offer dental insurance, and the private insurer will be responsible for virtually all aspects of the administration of the dental insurance program.
The latest form for Application Requirements to Receive VA Dental Insurance Plan Benefits under 38 CFR 17.169 expires 2020-06-30 and is listed under ICR 201611-2900-004.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 VADIP_Fact_Sheet_v14.pdf | Supplementary Document |
 2900-0789 Application for Dental Insurance_011117.docx | Supporting Statement A |
 Application Requirements to Receive VA Dental Insurance Plan Benefits under 38 CFR 17.169 |
Other-Fact Sheet |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201611-2900-004 | Extension without change of a currently approved collection | 2017-01-11 | Approved without change | |
| 201301-2900-002 | New collection (Request for a new OMB Control Number) | 2013-09-03 | Approved with change | |
| 201206-2900-010 | New collection (Request for a new OMB Control Number) | 2012-09-11 | Comment filed on proposed rule |