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

• Citation: 86 FR 60304
• Record Number: 2021-23740
• Published date: 01 November 2021
• Section: Notices
• Court: Personnel Management Office

Federal Register, Volume 86 Issue 208 (Monday, November 1, 2021)

[Federal Register Volume 86, Number 208 (Monday, November 1, 2021)]
                [Notices]
                [Page 60304]
                From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
                [FR Doc No: 2021-23740]
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                OFFICE OF PERSONNEL MANAGEMENT
                Submission for Review: 3206-0160, Health Benefits Election Form,
                Standard Form 2809
                AGENCY: Office of Personnel Management.
                ACTION: 60-Day notice and request for comments.
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                SUMMARY: Federal Employee Insurance Operations (FEIO), Healthcare &
                Insurance, Office of Personnel Management (OPM) offers the general
                public and other federal agencies the opportunity to comment on an
                expiring information collection request (ICR) without change, Health
                Benefits Election Form, Standard Form 2809.
                DATES: Comments are encouraged and will be accepted until January 3,
                2022.
                ADDRESSES: You may submit comments, identified by docket number and/or
                Regulatory Information Number (RIN) and title, by the following method:
                --Federal Rulemaking Portal: http://www.regulations.gov. Follow the
                instructions for submitting comments.
                 All submissions received must include the agency name and docket
                number or RIN for this document. The general policy for comments and
                other submissions from members of the public is to make these
                submissions available for public viewing at http://www.regulations.gov
                as they are received without change, including any personal identifiers
                or contact information.
                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 OPM is soliciting comments for this collection (OMB No. 3206-
                0160). 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 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, 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, Healthcare &
                Insurance, 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.
                Kellie Cosgrove Riley,
                Director, Office of Privacy and Information Management.
                [FR Doc. 2021-23740 Filed 10-29-21; 8:45 am]
                BILLING CODE 6325-38-P