Submission for OMB Review, Comment Request for Review; of a Revised Information Collection SF 2809

[Federal Register Volume 64, Number 19 (Friday, January 29, 1999)]
[Notices]
[Page 4727]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-2069]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review, Comment Request for Review; of a 
Revised Information Collection SF 2809

AGENCY: Office of Personnel Management.

ACTION: Notice.

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SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Public 
Law 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management has submitted to the Office of Management and 
Budget a request for review of a revised information collection. SF 
2809, Federal Employees Health Benefits Election Form, is used by 
Federal employees, certain separated former Federal employees, and 
former dependents of Federal employees, to enroll for health insurance 
coverage under the FEHB Program. Certain former spouses or former 
Federal employees who are eligible for enrollment under the Spouse 
Equity Act of 1984 (Pub. L. 98-615), and former spouse employees and 
former dependents who are eligible for enrollment under the Temporary 
Continuation of Coverage (TCC) provisions of FEHB law (5 U.S.C. 8905a) 
also use this form.
    Approximately 9,000 SF 2809 forms are completed annually. Each form 
takes approximately 30 minutes to complete. The annual estimated burden 
is 4,500 hours.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, or E-mail to mbtoomey@opm.gov.

DATES: Comments on this proposal should be received by March 1, 1999.

ADDRESSES: Send or deliver comments to--

Abby L. Block, Chief, Insurance Policy and Information Division, 
Retirement and Insurance Service, U.S. Office of Personnel Management, 
1900 E Street, NW, Room 3425, Washington, DC 20415-0001.

and

Joseph Lackey, OPM Desk Officer, Office of Information and Regulatory 
Affairs, Office of Management and Budget, New Executive Office 
Building, NW, Room 3002, Washington, DC 20503.

FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION--CONTACT: Donna 
G. Lease, Budget and Administrative Services Division, (202) 606-0623.

    U.S. Office of Personnel Management.
Janice R. Lachance,
Director.
[FR Doc. 99-2069 Filed 1-28-99; 8:45 am]
BILLING CODE 6325-01-M