Notice of Special Enrollment
Rights under Group Health Plans
Extension without change of a currently approved collection
No
Regular
08/05/2025
Requested
Previously Approved
36 Months From Approved
08/31/2025
10,585,910
8,618,763
0
552
110,358
430,938
Section 701(f) of the Employee
Retirement Income Security Act (ERISA) provides special enrollment
rights to individuals who have previously declined health coverage
offered to them to enroll in health coverage upon the occurrence of
specified events, including when they lose other coverage, when
employer contributions to the cost of other coverage cease, and
when they marry, have a child or adopt a child (“special enrollment
events”). Plans and issuers are required to provide for 30-day
special enrollment periods following any of these events during
which individuals who are eligible but not enrolled have a right to
enroll without being denied enrollment or having to wait for a late
enrollment opportunity (often called “open enrollment”). A group
health plan may require, as a pre-condition to having a special
enrollment right to enroll in group health coverage after losing
eligibility under other coverage, that an employee or beneficiary
who declines coverage provide the plan a written statement
declaring whether he or she is declining coverage because of having
other coverage. Failure to provide such a written statement can
then be treated as eliminating the individual's right to special
enrollment upon losing eligibility for such other coverage. The
regulations further establish that the right to special enroll can
be denied in such circumstances only if employees are given notice
of the requirement for a written statement and the consequences of
failing to provide the written statement at the time an employee
declines enrollment. As part of the special enrollment notice, it
must be given at or before the time the employee is initially
offered the opportunity to enroll. This information collection
request covers the requirement in the implementing regulations
under section 701(f) for a special enrollment notice. This
information collection implements the disclosure obligation of a
plan to inform all employees, at or before the time they are
initially offered the opportunity to enroll in the plan, of the
plan's special enrollment rules. The regulations require plans and
their issuers to provide all employees with a notice describing
their special enrollment rights, whether or not they enroll. A
group health plan may require, as a pre-condition to having a
special enrollment right to enroll in group health coverage after
losing eligibility under other coverage, that an employee or
beneficiary who declines coverage provide the plan a written
statement declaring whether he or she is declining coverage because
of having other coverage. Failure to provide such a written
statement can then be treated as eliminating the individual's right
to special enrollment upon losing eligibility for such other
coverage. The regulations further establish that the right to
special enroll can be denied in such circumstances only if
employees are given notice of the requirement for a written
statement and the consequences of failing to provide the written
statement at the time an employee declines enrollment. As part of
the special enrollment notice, it must be given at or before the
time the employee is initially offered the opportunity to enroll.
This information collection request covers the requirement in the
implementing regulations under section 701(f) for a special
enrollment notice. This information collection implements the
disclosure obligation of a plan to inform all employees, at or
before the time they are initially offered the opportunity to
enroll in the plan, of the plan's special enrollment rules. The
regulations require plans and their issuers to provide all
employees with a notice describing their special enrollment rights,
whether or not they enroll.
US Code:
29
USC 1191c Name of Law: Employee Retirement Income Security Act
of 1974
Since the last ICR submission,
the Department has updated its estimates and assumptions. First,
the Department has also updated the number of job changers. The
Department has also assumed a de minimis cost for preparing the
notice, which has resulted in a reduction of the hour burden and
equivalent cost. Additionally, the Department has revised its
estimate of the material cost from $0.10 down to $0.05, based on
the length of the model notice. Finally, the Department has assumed
some share of the notices will be delivered electronically. As a
result, the number of responses has increased by 1,967,147
responses, the hour burden has decreased by 552 hours, and the cost
burden has increased by $320,315.
$0
No
No
No
No
No
No
No
James Butikofer 202 693-8434
Butikofer.James@dol.gov
No
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
1210-0101 HIPAA Enrollment Rights SS 7.21.25.docx
Notice of Special Enrollment Rights under Group Health Plans