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Agency Information Collection Activities; Submission for OMB Review; Comment Request; Notice of Pre-Existing Condition Exclusion Under Group Health Plans

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Information about this document as published in the Federal Register.

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The Department of Labor (DOL) is submitting the Employee Benefits Security Administration (EBSA) sponsored information collection request (ICR) titled, “Notice of Pre-Existing Condition Exclusion Under Group Health Plans,” to the Office of Management and Budget (OMB) for review and approval for continued use in accordance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501 et seq.).


Submit comments on or before January 25, 2013.


A copy of this ICR with applicable supporting documentation; including a description of the likely respondents, proposed frequency of response, and estimated total burden may be obtained from the Web site,, on the day following publication of this notice or by contacting Michel Smyth by telephone at 202-693-4129 (this is not a toll-free number) or sending an email to

Submit comments about this request to the Office of Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL-EBSA, Office of Management and Budget, Room 10235, 725 17th Street NW., Washington, DC 20503, Fax: 202-395-6881 (this is not a toll-free number), email:


Michel Smyth by telephone at 202-693-4129 (this is not a toll-free number) or by email at


An employee group health benefit plan or its issuer that imposes a preexisting condition exclusion period must give, as part of any enrollment application, an employee eligible for coverage a general notice that describes the plan's preexisting condition exclusion—including that the plan will reduce the maximum exclusion period by the length of an employee's prior creditable coverage. If there are no such enrollment materials, the notice must be provided as soon after a request for enrollment as is reasonably possible. The EBSA has provided sample language for the general notice. See 29 CFR 2590.701-3(c).

A plan that uses the alternative method of crediting coverage provided in the applicable regulations must disclose the use of that method at the time of enrollment and describe how the method operates. The plan must also explain that a participant has a right to establish prior creditable coverage through a certificate or other means and to request a certificate of prior coverage from a prior plan or issuer. Finally, a plan or issuer must offer to assist the participant in obtaining a certificate from a prior plan or issuer, if necessary. See 29 CFR 2590.701-4(c)(4).

This information collection is subject to the PRA. A Federal agency generally cannot conduct or sponsor a collection of information, and the public is generally not required to respond to an information collection, unless it is approved by the OMB under the PRA and displays a currently valid OMB Control Number. In addition, notwithstanding any other provisions of law, no person shall generally be subject to penalty for failing to comply with a collection of information that does not display a valid Control Number. See 5 CFR 1320.5(a) and 1320.6. The DOL obtains OMB approval for this information collection under Control Number 1210-0102. The current approval is scheduled to expire on December 31, 2012; however, it should be noted that existing information collection requirements submitted to the OMB receive a month-to-month extension while they undergo review. For additional information, see the related notice published in the Federal Register on June 25, 2012 (77 FR 37920).

Interested parties are encouraged to send comments to the OMB, Office of Information and Regulatory Affairs at the address shown in the ADDRESSES section within 30 days of publication of this notice in the Federal Register. In order to help ensure appropriate consideration, comments should mention OMB Control Number 1210-0102. The OMB is particularly interested in comments that:

  • 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;
  • 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;
  • Enhance the quality, utility, and clarity of the information to be collected; and
  • 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 submission of responses.

Agency: DOL-EBSA.

Title of Collection: Notice of Pre-Existing Condition Exclusion Under Group Health Plans.

OMB Control Number: 1210-0102.

Affected Public: Private Sector—businesses or other for-profits and not-for-profit institutions.

Total Estimated Number of Respondents: 685,114.

Total Estimated Number of Responses: 1,666,339.

Total Estimated Annual Burden Hours: 5,043.

Total Estimated Annual Other Costs Burden: $1,052,061.

Authority: 44 U.S.C. 3507(a)(1)(D).

Dated: December 19, 2012.

Michel Smyth,

Departmental Clearance Officer.

[FR Doc. 2012-30964 Filed 12-21-12; 4:15 pm]