[Federal Register Volume 84, Number 161 (Tuesday, August 20, 2019)]
[Notices]
[Page 43191]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-17915]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for Review: Health Benefits Election Form, OPM 2809, 
3206-0141

AGENCY: U.S. Office of Personnel Management.

ACTION: 60-Day Notice and request for comments.

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SUMMARY: The Retirement Services, Office of Personnel Management (OPM) 
offers the general public and other federal agencies the opportunity to 
comment on a revised information collection request (ICR), Health 
Benefits Election Form (OPM 2809).

DATES: Comments are encouraged and will be accepted until October 21, 
2019.

ADDRESS:  Interested persons are invited to submit written comments on 
the proposed information collection to Retirement Services, U.S. Office 
of Personnel Management, 1900 E Street NW, Washington, DC 20415, 
Attention: Alberta Butler, Room 2523-AC, or sent via electronic mail 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, 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 (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 (OMB No. 3206-0141). 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.
    OPM 2809, Health Benefits Election, is used by annuitants and 
former spouses to elect, cancel, suspend, or change health benefits 
enrollment during periods other than open season.

Analysis

    Agency: Federal Employee Insurance Operations, Office of Personnel 
Management.
    Title: Health Benefits Election Form.
    OMB Number: 3206-0141.
    Frequency: On occasion.
    Affected Public: Individuals or Households.
    Number of Respondents: 30,000 (Forms = 20,000; Verbal/Written 
collection = 10,000).
    Estimated Time per Respondent: 30 minutes (Telephone/Mail 
collection = 10 mins).
    Total Burden Hours: 11,667 hours.

    U.S. Office of Personnel Management.
Stephen Hickman,
Federal Register Liaison.
[FR Doc. 2019-17915 Filed 8-19-19; 8:45 am]
 BILLING CODE 6325-38-P