[Federal Register Volume 70, Number 250 (Friday, December 30, 2005)]
[Notices]
[Pages 77438-77439]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E5-8094]


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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 collection(s) should be 
submitted to the SSA Reports Clearance Officer. The information can be 
mailed and/or faxed to the individuals at the addresses and fax number 
listed below:
    (SSA), Social Security Administration, DCFAM, Attn: Reports 
Clearance Officer, 1333 Annex Building, 6401 Security Blvd., Baltimore, 
MD 21235. Fax: 410-965-6400. E-mail: [email protected].
    The information collection listed below is 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.
    Redetermination of Eligibility for Help with Medicare Prescription 
Drug Plan Costs--0960-NEW. Under the aegis of the Medicare 
Modernization Act of 2003 (Pub. L. 108-173), SSA will conduct low-
income subsidy eligibility redeterminations for Medicare beneficiaries 
who filed for the subsidy and were determined by SSA to be eligible. 
Subsidy eligibility redeterminations will be conducted when: (1) 
Medicare Part D subsidy beneficiaries use form SSA-1026-RET to report a 
change in income, resources, or household information in response to 
SSA's inquiry via form SSA-L1026; (2) Medicare Part D subsidy 
beneficiaries report a change in income, resources, or household 
information on their own using form SSA-1026-RET; (3) Medicare Part D 
subsidy beneficiaries use form SSA-1026-SCE to report a subsidy-
changing event which could potentially impact the amount of their 
subsidy, including marriage, separation, divorce/annulment, or spousal 
death. The respondents are current recipients of the Medicare Part D 
low-income subsidy who will undergo an eligibility redetermination for 
one of the reasons mentioned above. Following is a description of the 
forms in this collection, the number of respondents who will complete 
them, and their burden data.

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                                                                                          Average
                                                                            Frequency    burden per   Estimated
            Form                        Explanation            Number of   of response    response      annual
                                                              respondents   (per year)      (in       burden (in
                                                                                          minutes)      hours)
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SSA-L1026...................  Passive redetermination letter    1,500,000            1            5      125,000
                               informing Medicare Part D
                               subsidy recipients what
                               income, resource, and
                               household information SSA has
                               on file for them, and asking
                               if this information has
                               changed.
SSA-1026-RET................  Redetermination form completed      300,000            1           20      100,000
                               by Medicare Part D subsidy
                               recipients who said their
                               income, resource, or
                               household information had
                               changed in their response to
                               form SSA-L1026. Beginning in
                               2007, this form will also be
                               used as a cyclical
                               redetermination form to be
                               completed by Medicare Part D
                               subsidy recipients who are
                               automatically sent the form
                               based on certain profile/
                               selection criteria.
SSA-1026-SCE................  Redetermination form completed       76,000            1           20       25,333
                               by Medicare Part D subsidy
                               recipients who called SSA to
                               inform them of an event which
                               is potentially subsidy-
                               changing (marriage, divorce,
                               annulment, legal separation,
                               spousal death). This form,
                               which is identical to form
                               SSA-1026-RET but has a
                               different cover sheet, will
                               replace form OMB No. 0960-
                               0703 (SSA-1020-SC).
    Total...................  ..............................    1,876,000           --           --      250,333
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[[Page 77439]]

    Dated: December 23, 2005.
Elizabeth A. Davidson,
Reports Clearance Officer, Social Security Administration.
[FR Doc. E5-8094 Filed 12-29-05; 8:45 am]
BILLING CODE 4191-02-P