Submission for Review: Standard Form 2809, Health Benefits Election Form, 36582-36583 [2011-15596]

Agencies

• Office of Personnel Management
• Personnel Management Office

[Federal Register Volume 76, Number 120 (Wednesday, June 22, 2011)]
[Notices]
[Pages 36582-36583]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-15596]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for Review: Standard Form 2809, Health Benefits 
Election Form

AGENCY: U.S. Office of Personnel Management.

ACTION: 30-Day Notice and request for comments.

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SUMMARY: The Retirement Services, Office of Personnel Management (OPM) 
offers the general public and other Federal agencies the opportunity to 
comment on a revised information collection request (ICR) 3206-0160, 
Health Benefits Election Form. As required by the Paperwork Reduction 
Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35) as amended by the 
Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting comments for 
this collection. The information collection was previously published in 
the Federal Register on July 9, 2010 at Volume 75 FR 39587 allowing for 
a 60-day public comment period. We received comments from one 
organization. Based on the comments, several changes were made to the 
form including changes that make it consistent with the Affordable Care 
Act (Pub. L. 111-48). The purpose of this notice is to allow an 
additional 30 days for public comments. The Office of Management and 
Budget is particularly interested in comments that:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of 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.

DATES:  Comments are encouraged and will be accepted until July 22, 
2011. This process is conducted in accordance with 5 CFR 1320.1.

ADDRESSES:  Interested persons are invited to submit written comments 
on the proposed information collection to the Office of Information and 
Regulatory Affairs, Office of Management and Budget, 725 17th Street, 
NW., Washington, DC 20503, Attention: Desk Officer for the Office of 
Personnel Management or sent via electronic mail to oira_submission@omb.eop.gov or faxed to (202) 395-6974.

FOR FURTHER INFORMATION CONTACT:  A copy of this ICR, with applicable 
supporting documentation, may be obtained by contacting the Office of 
Information and Regulatory Affairs, Office of Management and Budget, 
725 17th Street, NW., Washington, DC 20503, Attention: Desk Officer for 
the Office of Personnel Management or sent via electronic mail to 
oira_submission@omb.eop.gov or faxed to (202) 395-6974.

SUPPLEMENTARY INFORMATION:  The Health Benefits Election Form is used

[[Page 36583]]

by Federal employees, annuitants other than those under the Civil 
Service Retirement System (CSRS) and the Federal Employees Retirement 
System (FERS) including individuals receiving benefits from the Office 
of Workers' Compensation Programs, former spouses eligible for benefits 
under the Spouse Equity Act of 1984, and separated employees and former 
dependents eligible to enroll under the Temporary Continuation of 
Coverage provisions of the FEHB law (5 U.S.C. 8905a). A different form 
(OPM 2809) is used by CSRS and FERS annuitants whose health benefit 
enrollments are administered by OPM's Retirement Operations.

Analysis

    Agency: Insurance Operations, Healthcare and Insurance, Office of 
Personnel Management.
    Title: Health Benefits Election Form.
    OMB Number: 3206-0160.
    Frequency: On occasion.
    Affected Public: Individuals or Households.
    Number of Respondents: 18,000.
    Estimated Time per Respondent: 30 minutes.
    Total Burden Hours: 9,000.

U.S. Office of Personnel Management.
John Berry,
Director.
[FR Doc. 2011-15596 Filed 6-21-11; 8:45 am]
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