[Federal Register Volume 67, Number 13 (Friday, January 18, 2002)]
[Notices]
[Page 2704]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-1323]


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

OFFICE OF PERSONNEL MANAGEMENT


Proposed Collection; Comment Request for Review of an Expiring 
Information Collection: SF 2809

AGENCY: Office of Personnel Management.

ACTION: Notice.

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

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Public 
Law 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management (OPM) intends to submit to the Office of 
Management and Budget (OMB) a request for review of an expiring 
information collection. SF 2809, Employee Health Benefits Election 
Form, is used by Federal employees, certain separated former Federal 
employees, and former dependents of Federal employees, to enroll for 
health insurance coverage under the Federal Employees Health Benefits 
(FEHB) Program. Certain former spouses who are eligible for enrollment 
under the Spouse Equity Act of 1984 (Pub. L. 98-615), and former 
employees and former dependents who are eligible for enrollment under 
the Temporary Continuation of Coverage (TCC) provisions of FEHB law (5 
U.S.C. 8905a) also use this form.
    Approximately 9,000 SF 2809 forms are completed annually. Each form 
takes approximately 30 minutes to complete. The annual estimated burden 
is 4,500 hours.
    Comments are particularly invited on: whether this information is 
necessary for the proper performance of functions of the Office of 
Personnel Management, and whether it will have practical utility; 
whether our estimate of the public burden of this collection of 
information is accurate, and based on valid assumptions and 
methodology; and ways in which we can minimize the burden of the 
collection of information on those who are to respond, through the use 
of appropriate technological collection techniques or other forms of 
information technology.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, FAX (202) 418-3251 or e-mail to [email protected]. 
Please be sure to include a mailing address with your request.

DATES: Comments on this proposal should be received on or before March 
19, 2002.

ADDRESSES: Send or deliver comments to--Abby L. Block, Assistant 
Director, Office of Insurance Programs, Retirement and Insurance 
Service, U.S. Office of Personnel Management, 1900 E Street, NW, Room 
3400, Washington, DC 20415.

For Information Regarding Administrative Coordination--Contact: Donna 
G. Lease, Team Leader, Budget & Administrative Services Division, (202) 
606-0623.

Office of Personnel Management.
Kay Coles James,
Director.
[FR Doc. 02-1323 Filed 1-17-02; 8:45 am]
BILLING CODE 6325-50-P