[Federal Register Volume 84, Number 57 (Monday, March 25, 2019)]
[Notices]
[Page 11141]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-05559]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for Review: Health Benefits Election Form, Standard 
Form 2809

AGENCY: Office of Personnel Management.

ACTION: 30-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, Health Benefits Election Form, 
Standard Form 2809.

DATES: Comments are encouraged and will be accepted until April 24, 
2019.

ADDRESSES: Interested persons are invited to submit written comments on 
the proposed information collection to the Office of Information and 
Regulatory Affairs, Office of Management and Budget, 725 17th Street 
NW, Washington, DC 20503, Attention: Desk Officer for the Office of 
Personnel Management or sent via electronic mail to 
[email protected] or faxed to (202) 395-6974.

FOR FURTHER INFORMATION CONTACT: A copy of this information collection, 
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. The information 
collection (OMB No. 3206-0160) was previously published in the Federal 
Register on December 4, 2018, at 83 FR 62630, allowing for a 60-day 
public comment period. No comments were received for this collection. 
The purpose of this notice is to allow an additional 30 days for public 
comments. 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;
    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 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 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.
Alexys Stanley,
Regulatory Affairs Analyst.
[FR Doc. 2019-05559 Filed 3-22-19; 8:45 am]
 BILLING CODE 6325-38-P