Submission for Review: 3206-0141, Health Benefits Election Form, OPM 2809
Agency: "
SUMMARY: The Healthcare & Insurance/Federal Employee Insurance Operations (FEIO) offers the general public and other federal agencies the opportunity to comment on a revised information collection request OPM 2809, Health Benefits Election Form.
DATES: Comments are encouraged and will be accepted until
ADDRESSES: Interested persons are invited to submit written comments on the proposed information collection to the
FOR FURTHER INFORMATION CONTACT: A copy of this information collection, with applicable supporting documentation, may be obtained by contacting the Retirement Services Publications Team,
SUPPLEMENTARY INFORMATION: As required by the Paperwork Reduction Act of 1995 OPM is soliciting comments for this collection. The information collection (OMB No. 3206-0141) was previously published in the
1. Evaluate whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used;
3. Enhance the quality, utility, and clarity of the information to be collected; and
4. Minimize the burden of the collection of information on those who are to respond, including through the use of appropriate automated, electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submissions of responses.
OPM 2809, Health Benefits Election form, is used by annuitants and former spouses to elect, cancel, suspend, or change health benefits enrollment during periods other than open season.
Analysis
Agency: Retirement Operations, Retirement Services,
Title: Health Benefits Election Form.
OMB Number: 3206-0141.
Frequency: On Occasion.
Affected Public: Individuals or Households.
Number of Respondents: 30,000.
Estimated Time per Respondent: 30 minutes.
Total
Regulatory Affairs Analyst.
30-Day notice and request for comments.
Citation: "85 FR 11399"
Federal Register Page Number: "11399"
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