[Federal Register Volume 79, Number 80 (Friday, April 25, 2014)]
[Notices]
[Pages 23020-23021]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-09493]


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OFFICE OF PERSONNEL MANAGEMENT


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

AGENCY: U.S. Office of Personnel Management.

ACTION: 60-Day Notice and request for comments.

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SUMMARY: The Healthcare & Insurance/Federal Employee Insurance 
Operations (FEIO), Office of Personnel Management (OPM) offers the 
general public and other Federal agencies the opportunity to comment on 
a revised information collection request (ICR) 3206-0160, Health 
Benefits Election Form. As required by the Paperwork Reduction Act of 
1995, (Pub. L. 104-13, 44 U.S.C. chapter 35) as amended by the Clinger-
Cohen Act (Pub. L. 104-106), OPM is soliciting comments for this 
collection.

DATES: Comments are encouraged and will be accepted until June 24, 
2014. This process is conducted in accordance with 5 CFR 1320.1.

ADDRESSES: Interested persons are invited to submit written comments on 
the proposed information collection to the Healthcare & Insurance/FEIO, 
Office of Personnel Management, 1900 E. Street NW., Washington, DC 
20415, Attention: Jay Fritz or sent via email to [email protected].

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., Washington, DC 20503, Attention: Cyrus S. Benson or sent 
via email to [email protected].

SUPPLEMENTARY INFORMATION: 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 the functions of the agency, 
including whether the information will have practical utility;

[[Page 23021]]

    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.
    The 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, Office of Personnel 
Management.
    Title: Health Benefits Election Form.
    OMB Number: 3206-0160.
    Frequency: On ocassion.
    Affected Public: Individuals or households.
    Number of Respondents: 18,000.
    Estimated Time Per Respondent: 30 minutes.
    Total Burden Hours: 9,000.

U.S. Office of Personnel Management.
Katherine Archuleta,
Director.
[FR Doc. 2014-09493 Filed 4-24-14; 8:45 am]
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