Submission for Review: 3206-0160, Health Benefits Election Form, Standard Form 2809, 60304 [2021-23740]

Download as PDF lotter on DSK11XQN23PROD with NOTICES1 60304 Federal Register / Vol. 86, No. 208 / Monday, November 1, 2021 / Notices Advisory Committee members must have experience with employee organizations, employers who maintain defined benefit pension plans, the administration or advising of pension plans, or in related fields. Appointments are for 3-year terms. Reappointments are possible but are subject to the appointment process. The Advisory Committee’s prescribed duties include advising the Corporation as to its policies and procedures relating to investment of moneys, and other issues as the Corporation may request or as the Advisory Committee determines appropriate. The Advisory Committee meets at least six times each year. At least one meeting is a joint meeting with the PBGC Board of Directors. By February 19, 2022, the terms of three of the Advisory Committee members, one representing the general public and two representing employers, will have expired. Therefore, PBGC is seeking nominations for three seats. PBGC is committed to equal opportunity in the workplace and seeks a broad-based and diverse Advisory Committee. If you or your organization wants to nominate one or more people for appointment to the Advisory Committee to represent the general public or employers, you may submit nominations to PBGC. Nominations may be in the form of a letter, resolution or petition, signed by the person making the nomination. PBGC encourages you to include additional supporting letters of nomination. PBGC will not consider self-nominees who have no supporting letters. Please do not include any information that you do not want publicly disclosed. Nominations, including supporting letters, should: • State the person’s qualifications to serve on the Advisory Committee (including any specialized knowledge or experience relevant to the nominee’s proposed Advisory Committee position to represent the general public or employers); • state that the candidate will accept appointment to the Advisory Committee if offered; • include the nominee’s full name, work affiliation, mailing address, phone number, and email address; • include the nominator’s full name, mailing address, phone number, and email address; and • include the nominator’s signature, whether sent by email or otherwise. PBGC will contact nominees for information on their political affiliation and their status as registered lobbyists. Nominees should be aware of the time commitment for attending meetings and VerDate Sep<11>2014 18:03 Oct 29, 2021 Jkt 256001 actively participating in the work of the Advisory Committee. Historically, this has meant a commitment of at least 15 days per year. PBGC has a process for vetting nominees under consideration for appointment. Issued in Washington, DC. Gordon Hartogensis, Director, Pension Benefit Guaranty Corporation. [FR Doc. 2021–23717 Filed 10–29–21; 8:45 am] BILLING CODE 7709–02–P OFFICE OF PERSONNEL MANAGEMENT Submission for Review: 3206–0160, Health Benefits Election Form, Standard Form 2809 Office of Personnel Management. ACTION: 60-Day notice and request for comments. AGENCY: Federal Employee Insurance Operations (FEIO), Healthcare & Insurance, Office of Personnel Management (OPM) offers the general public and other federal agencies the opportunity to comment on an expiring information collection request (ICR) without change, Health Benefits Election Form, Standard Form 2809. DATES: Comments are encouraged and will be accepted until January 3, 2022. ADDRESSES: You may submit comments, identified by docket number and/or Regulatory Information Number (RIN) and title, by the following method: —Federal Rulemaking Portal: https:// www.regulations.gov. Follow the instructions for submitting comments. All submissions received must include the agency name and docket number or RIN for this document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing at https:// www.regulations.gov as they are received without change, including any personal identifiers or contact information. SUMMARY: A copy of this ICR with applicable supporting documentation, may be obtained by contacting the Retirement Services Publications Team, Office of Personnel Management, 1900 E Street NW, Room 3316–L, Washington, DC 20415, Attention: Cyrus S. Benson, or sent via electronic mail to Cyrus.Benson@opm.gov or faxed to (202) 606–0910 or via telephone at (202) 606–4808. FOR FURTHER INFORMATION CONTACT: PO 00000 Frm 00107 Fmt 4703 Sfmt 9990 As required by the Paperwork Reduction Act of 1995 OPM is soliciting comments for this collection (OMB No. 3206– 0160). 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. Standard Form 2809, Health Benefits Election Form, is used 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. SUPPLEMENTARY INFORMATION: Analysis Agency: Federal Employee Insurance Operations, Healthcare & 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. Office of Personnel Management. Kellie Cosgrove Riley, Director, Office of Privacy and Information Management. [FR Doc. 2021–23740 Filed 10–29–21; 8:45 am] BILLING CODE 6325–38–P E:\FR\FM\01NON1.SGM 01NON1

Agencies

Office of Personnel Management

[Federal Register Volume 86, Number 208 (Monday, November 1, 2021)]
[Notices]
[Page 60304]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-23740]


=======================================================================
-----------------------------------------------------------------------

OFFICE OF PERSONNEL MANAGEMENT


Submission for Review: 3206-0160, Health Benefits Election Form, 
Standard Form 2809

AGENCY: Office of Personnel Management.

ACTION: 60-Day notice and request for comments.

-----------------------------------------------------------------------

SUMMARY: Federal Employee Insurance Operations (FEIO), Healthcare & 
Insurance, Office of Personnel Management (OPM) offers the general 
public and other federal agencies the opportunity to comment on an 
expiring information collection request (ICR) without change, Health 
Benefits Election Form, Standard Form 2809.

DATES: Comments are encouraged and will be accepted until January 3, 
2022.

ADDRESSES: You may submit comments, identified by docket number and/or 
Regulatory Information Number (RIN) and title, by the following method:

--Federal Rulemaking Portal: https://www.regulations.gov. Follow the 
instructions for submitting comments.

    All submissions received must include the agency name and docket 
number or RIN for this document. The general policy for comments and 
other submissions from members of the public is to make these 
submissions available for public viewing at https://www.regulations.gov 
as they are received without change, including any personal identifiers 
or contact information.

FOR FURTHER INFORMATION CONTACT: A copy of this ICR with applicable 
supporting documentation, may be obtained by contacting the Retirement 
Services Publications Team, Office of Personnel Management, 1900 E 
Street NW, Room 3316-L, Washington, DC 20415, Attention: Cyrus S. 
Benson, or sent via electronic mail to [email protected] or faxed to 
(202) 606-0910 or via telephone at (202) 606-4808.

SUPPLEMENTARY INFORMATION: As required by the Paperwork Reduction Act 
of 1995 OPM is soliciting comments for this collection (OMB No. 3206-
0160). 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.
    Standard Form 2809, Health Benefits Election Form, is used 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: Federal Employee Insurance Operations, Healthcare & 
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.

Office of Personnel Management.
Kellie Cosgrove Riley,
Director, Office of Privacy and Information Management.
[FR Doc. 2021-23740 Filed 10-29-21; 8:45 am]
BILLING CODE 6325-38-P

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.