Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans, 11283 [2011-4410]

Agencies

• DEPARTMENT OF LABOR
• Office of the Secretary

[Federal Register Volume 76, Number 40 (Tuesday, March 1, 2011)]
[Notices]
[Page 11283]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-4410]



[[Page 11283]]

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DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Affordable Care Act Internal Claims and 
Appeals and External Review Procedures for Non-Grandfathered Plans

ACTION: Notice.

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SUMMARY: The Department of Labor (DOL) is submitting the Employee 
Benefits Security Administration (EBSA) sponsored information 
collection request (ICR) titled, ``Affordable Care Act Internal Claims 
and Appeals and External Review Procedures for Non-grandfathered 
Plans,'' to the Office of Management and Budget (OMB) for review and 
approval for continued use in accordance with the Paperwork Reduction 
Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 35).

DATES: Submit comments on or before March 31, 2011.

ADDRESSES: A copy of this ICR, with applicable supporting 
documentation, including a description of the likely respondents, 
proposed frequency of response, and estimated total burden may be 
obtained from the RegInfo.gov Web site, https://www.reginfo.gov/public/do/PRAMain, on the day following publication of this notice or by 
contacting Michel Smyth by telephone at 202-693-4129 (this is not a 
toll-free number) or sending an e-mail to DOL_PRA_PUBLIC@dol.gov.
    Submit comments about this request to the Office of Information and 
Regulatory Affairs, Attn: OMB Desk Officer for the U.S. Department of 
Labor, Employee Benefits Security Administration (EBSA), Office of 
Management and Budget, Room 10235, Washington, DC 20503, Telephone: 
202-395-6929/Fax: 202-395-6881 (these are not toll-free numbers), e-
mail: OIRA_submission@omb.eop.gov.

FOR FURTHER INFORMATION CONTACT: Michel Smyth by telephone at 202-693-
4129 (this is not a toll-free number) or by e-mail at DOL_PRA_PUBLIC@dol.gov.

SUPPLEMENTARY INFORMATION: The Affordable Care Act added Public Health 
Service Act section 2719, which provides rules relating to internal 
claims and appeals and external review processes. On July 23, 2010, the 
EBSA issued interim final regulations to implement the statutory 
provision. See 75 FR 43330. With respect to internal claims and appeals 
processes for group health coverage, group health plans and health 
insurance issuers offering group health insurance coverage must comply 
with the internal claims and appeals processes set forth in 29 CFR 
2560.503-1 (the DOL claims procedure regulation) and update such 
processes in accordance with standards established by the Secretary of 
Labor. Group health plans and issuers offering group health insurance 
coverage must comply with either a State external review process or a 
Federal review process. The regulations provide a basis for determining 
when plans and issuers must comply with an applicable State external 
review process and when they must comply with the Federal external 
review process.
    The claims procedure regulation imposes information collections, as 
part of the reasonable procedures that an employee benefit plan must 
establish regarding the handling of a benefit claim. These information 
collections include third-party notice and disclosure requirements that 
the plan must satisfy by providing information to participants and 
beneficiaries of the plan; consequently, the collections are subject to 
the PRA. A Federal agency generally cannot conduct or sponsor a 
collection of information, and the public is generally not required to 
respond to an information collection, unless it is approved by the OMB 
under the PRA and displays a currently valid OMB Control Number. In 
addition, notwithstanding any other provisions of law, no person shall 
generally be subject to penalty for failing to comply with a collection 
of information if the collection of information does not display a 
valid OMB Control Number. See 5 CFR 1320.5(a) and 1320.6. The DOL 
obtains OMB approval for these information collections under OMB 
Control Number 1210-0144. The current OMB approval is scheduled to 
expire on February 28, 2011; however, it should be noted that 
information collections submitted to the OMB receive a month-to-month 
extension while they undergo review. For additional information, see 
the related notice published in the Federal Register on December 10, 
2010.
    Interested parties are encouraged to send comments to the OMB, 
Office of Information and Regulatory Affairs at the address shown in 
the ADDRESSES section within 30 days of publication of this notice in 
the Federal Register. In order to ensure appropriate consideration, 
comments should reference OMB Control Number 1210-0144. The OMB is 
particularly interested in comments that:
     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;
     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;
     Enhance the quality, utility, and clarity of the 
information to be collected; and
     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 submission of responses.
    Agency: Employee Benefits Security Administration (EBSA).
    Title of Collection: Affordable Care Act Internal Claims and 
Appeals and External Review Procedures for Non-grandfathered Plans.
    OMB Control Number: 1210-0144.
    Affected Public: Private sector--Businesses and other for-profits 
and Not-for-profit institutions.
    Total Estimated Number of Responses: 94,483.
    Total Estimated Annual Burden Hours: 631.
    Total Estimated Annual Costs Burden: $250,328.

    Dated: February 22, 2011.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2011-4410 Filed 2-28-11; 8:45 am]
BILLING CODE 4510-29-P