Submission for OMB Review; Comment Request for Review of a Revised and Expired Information Collection

OFFICE OF PERSONNEL MANAGEMENT

[OPM Form 2809]

Submission for OMB Review; Comment Request for Review of a

Revised and Expired Information Collection

AGENCY: Office of Personnel Management.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Pub.

[[Page 18946]]

L. 104-13, May 22, 1995), this notice announces that the Office of

Personnel Management (OPM) will submit to the Office of Management and

Budget a request for review of a revised and expired information

collection. OPM Form 2809, Health Benefits Registration Form, is used

by annuitants and former spouses to elect, cancel, or change health

benefits enrollment during periods other than open season.

There are approximately 30,000 changes to health benefits coverage

per year. Of these, 20,000 are submitted on OPM Form 2809 and 10,000

verbally or in written correspondence. Each form takes approximately 45

minutes to complete; data collection by telephone or mail takes

approximately 10 minutes. The annual burden for the form is 15,000

hours; the burden not using the form is 1,667 hours. The total burden

is 16,667.

For copies of this proposal, contact Mary Beth Smith-Toomey on

(202) 606-8358, or E-mail to [email protected].

DATES: Comments on this proposal should be received on or before May

17, 1999.

ADDRESSES: Send or deliver comments to--

Dennis A. Matteotti, Acting Chief, Operations Support Division,

Retirement and Insurance Service, U.S. Office of Personnel Management,

1900 E Street, NW, Room 3349, Washington, DC 20415

and

Joseph Lackey, OPM Desk Officer, Office of Information & Regulatory

Affairs, Office of Management & Budget, New Executive Office Building,

NW, Room 10235, Washington, DC 20503

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION CONTACT: Phyllis

R. Pinkney, Budget & Administrative Services Division, (202) 606-0623.

Office of Personnel Management.

Janice R. Lachance,

Director.

[FR Doc. 99-9528 Filed 4-15-99; 8:45 am]

BILLING CODE 6325-01-U