[Federal Register Volume 70, Number 12 (Wednesday, January 19, 2005)]
[Notices]
[Page 3093]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-1022]


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SOCIAL SECURITY ADMINISTRATION


Agency Information Collection Activities: Proposed Request

    The Social Security Administration (SSA) publishes a list of 
information collection packages that will require clearance by the 
Office of Management and Budget (OMB) in compliance with Public Law 
104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. 
The information collection packages that may be included in this notice 
are for new information collections.
    SSA is soliciting comments on the accuracy of the agency's burden 
estimate; the need for the information; its practical utility; ways to 
enhance its quality, utility, and clarity; and on ways to minimize 
burden on respondents, including the use of automated collection 
techniques or other forms of information technology. Written comments 
and recommendations regarding the information collections should be 
submitted to the SSA Reports Clearance Officer. The information can be 
mailed and/or faxed to the address and fax number listed below: (SSA), 
Social Security Administration, DCFAM, Attn: Reports Clearance Officer, 
1338 Annex Building, 6401 Security Blvd., Baltimore, MD 21235. Fax: 
410-965-6400. [email protected].
    The information collections listed below are pending at SSA and 
will be submitted to OMB within 60 days from the date of this notice. 
Therefore, your comments should be submitted to SSA within 60 days from 
the date of this publication. You can obtain copies of the collection 
instruments by calling the SSA Reports Clearance Officer at 410-965-
0454 or by writing to the address listed above.
    1. Application for Help with Medicare Prescription Drug Plan Costs, 
SSA-1020SC--0960-NEW. The Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (Public Law 108-173; MMA) establishes a new 
Medicare Part D program for voluntary prescription drug coverage for 
premium, deductible, and cost-sharing subsidies for certain low-income 
individuals. The MMA stipulates that subsidies must be available for 
individuals who are eligible for the program and who meet eligibility 
criteria for help with premium, deductible, and/or co-payment costs.
    Individuals who receive these subsidies may ask SSA to redetermine 
the amount of help they receive if they experience a ``subsidy-changing 
event,'' including marriage, separation, divorce, an annulment, or the 
death of a spouse. Until late 2006, when redetermination forms will 
become available, SSA will use form SSA-1020-SC, the Application for 
Help with Medicare Prescription Drug Plan Costs, to make 
redeterminations based on subsidy-changing events. The respondents are 
individuals whose application for help toward the costs for this 
program has been approved and are requesting a redetermination of their 
subsidy based on a subsidy-changing event.
    Type of Request: New information collection.
    Number of Respondents: 76,000.
    Frequency of Response: 1.
    Average Burden Per Response: 35 minutes.
    Estimated Annual Burden: 44,333 hours.
    2. Application for Help with Medicare Prescription Drug Plan 
Costs--0960-NEW (Internet/Intranet Application Screens). The Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003 (Public 
Law 108-173; MMA) establishes a new Medicare Part D program for 
voluntary prescription drug coverage for premium, deductible, and cost-
sharing subsidies for certain low-income individuals. The MMA 
stipulates that subsidies must be available for individuals who are 
eligible for the program and who meet eligibility criteria for help 
with premium, deductible, and/or co-payment costs. Form SSA-1020, the 
Application for Help with Medicare Prescription Drug Plan Costs, 
collects information about an applicant's resources and is used by SSA 
to determine eligibility for this assistance.
    We are proposing electronic versions of the SSA-1020, which will 
collect the information via the Intranet (the information is provided 
by the respondent during an interview at a Social Security field 
office) or the Internet (i1020) (if respondents complete the Internet 
screens on their own and submit them electronically). The respondents 
are individuals who are eligible for enrollment in the Medicare Part D 
program and are requesting assistance with the related costs.
    Type of Request: New information collection.
    Number of Respondents: 2,000,000.
    Frequency of Response: 1.
    Average Burden Per Response: 45 minutes.
    Estimated Annual Burden: 1,500,000.

    Dated: January 12, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 05-1022 Filed 1-18-05; 8:45 am]
BILLING CODE 4191-02-P