[Federal Register Volume 75, Number 131 (Friday, July 9, 2010)]
[Pages 39587-39588]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-16778]



[OMB Control No. 3206-0160; SF 2809]

Proposed Collection; Request for Comments on a Revised 
Information Collection

AGENCY: Office of Personnel Management.

ACTION: Notice.


SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Pub. 
L. 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management (OPM) intends to submit to the Office of 
Management and Budget (OMB) a request for comments on a revised 
information collection. This information collection, ``Health Benefits 
Election Form'' (OMB Control No. 3206-0160; SF 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.
    Comments Are Particularly Invited on: Whether this collection of 
information is necessary for the proper performance of functions of the 
Office of Personnel Management, and whether it will have practical 
utility; whether our estimate of the public burden of this collection 
of information is accurate, and based on valid assumptions and 
methodology; and ways in which we can minimize the burden of the 
collection of information on those who are to respond, through the use 
of appropriate technological collection techniques or other forms of 
information technology.

[[Page 39588]]

    Approximately 18,000 SF 2809 forms are completed annually. Each 
form takes approximately 30 minutes to complete. The annual estimated 
burden is 9,000 hours.
    For copies of this proposal, contact Cyrus S. Benson on (202) 606-
4808, FAX (202) 606-0910 or via e-mail to [email protected]. Please 
include a mailing address with your request.

DATES: Comments on this proposal should be received within 60 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--
    Jay Fritz, Program Analysis Officer, Program Planning and 
Evaluation, Retirement and Benefits/Insurance Operations, U.S. Office 
of Personnel Management, 1900 E Street, NW., Room 2H22, Washington, DC 
    For information regarding administrative coordination contact: 
Cyrus S. Benson, Team Leader, Publications Team, RB/RM/Administrative 
Services, (202) 606-4808.

U.S. Office of Personnel Management.
John Berry,
[FR Doc. 2010-16778 Filed 7-8-10; 8:45 am]