[Federal Register Volume 77, Number 125 (Thursday, June 28, 2012)]
[Pages 38681-38682]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-15856]



Submission for Review: Health Benefits Election Form, OPM 2809

AGENCY: U.S. Office of Personnel Management.

ACTION: 60-day notice and request for comments.


[[Page 38682]]

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) 3206-0141, 
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. 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.

DATES: Comments are encouraged and will be accepted until August 27, 
2012. 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 U.S. Office of Personnel 
Management, Attention: Alberta Butler, Union Square Room US 370, 1900 E 
Street NW., Washington, DC 20415-3500, 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, U.S. Office of Personnel Management, 1900 E 
Street NW., Room 4332, Washington, DC 20415, Attention: Cyrus S. 
Benson, or sent via electronic mail to [email protected] or faxed to 
(202) 606-0910.

SUPPLEMENTARY INFORMATION: OPM 2809 is used by annuitants and former 
spouses to elect, cancel, suspend, or change health benefits enrollment 
during periods other than open season.


    Agency: Retirement Operations, Retirement Services, 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.
    Estimated Time per Respondent: 30 minutes.
    Total Burden Hours: 15,000 hours.

    U.S. Office of Personnel Management.
John Berry,
[FR Doc. 2012-15856 Filed 6-27-12; 8:45 am]