[Federal Register: August 15, 2005 (Volume 70, Number 156)]
[Notices]               
[Page 47859]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr15au05-75]                         

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OFFICE OF PERSONNEL MANAGEMENT

 
Submission for OMB Review; Comment Request for Review of a 
Revised Information Collection: OPM 2809

AGENCY: Office of Personnel Management.

ACTION: Notice.

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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) has submitted to the Office of Management 
and Budget (OMB) a request for review of a revised information 
collection. OPM 2809, Health Benefits Election Form, is used by 
annuitants and former spouses to elect, cancel, suspend 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 hours.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, FAX (202) 418-3251 or via e-mail to mbtoomey@opm.gov. 
Please include a mailing address with your request.

DATES: Comments on this proposal should be received within 30 calendar 
days from the date of this publication.

ADDRESSES: Send or deliver comments to--Pamela Israel, Chief, 
Operations Support Group, Retirement Services Program, U.S. Office of 
Personnel Management, 1900 E Street, NW., Room 3349, Washington, DC 
20415; and Brenda Aguilar, OPM Desk Officer, Office of Information and 
Regulatory Affairs, Office of Management and Budget, New Executive 
Office Building, NW., Room 10235, Washington, DC 20503.

FOR FURTHER INFORMATION CONTACT: Cyrus S. Benson, Team Leader, 
Publications Team, Administrative Services Branch, (202) 606-0623.

Office of Personnel Management.
Linda M. Springer,
Director.
[FR Doc. 05-16091 Filed 8-12-05; 8:45 am]
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