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Federal forms, ICRs, and supporting documents

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Employee Benefits Security Administration

Agency prefix 1210 · EBSA · Federal forms and information collections.

Forms
OMB NumberTitle
1210-0172 Retirement Savings Lost and Found
1210-0171 Automatic Portability Transaction Regulations
1210-0170 Annual Information Return/Report of Employee Benefit Plan- SECURE Act
1210-0169 Requirements Related to No Surprise Billing Act, Part II (Independent Dispute Resolution Process) (CMS-10791)
1210-0168 Opt-in State Balance Bill Process
1210-0167 COBRA Continuation Coverage: Premium Assistance
1210-0166 Pension Benefit Statement
1210-0165 Fiduciary Duties Regarding Proxy Voting and Shareholder Rights
1210-0164 Registration Requirements to Serve as a Pooled Plan Provider to Pooled Employer Plans
1210-0163 Improving Investment Advice for Workers & Retirees Prohibited Transaction Exemption
1210-0162 Prudence and Loyalty in Selecting Plan Investments and Exercising Shareholder Rights
1210-0161 EBSA Participant Assistance Program Customer Survey
1210-0160 Notice for Health Reimbursement Arrangements Integrated with Individual Health Insurance Coverage
1210-0159 Insurance Marketing Organization Exemption
1210-0158 PTE 84-24 (Insurance and Annuity Contracts and Mutual Fund Principal Underwriters)
1210-0157 Proposed Class Exemption for Principal Transactions
1210-0156 Proposed Exemption for the Receipt of Compensation by Investment Advice Fiduciaries (Best Interest Contract PTE)
1210-0155 Conflicted Investment Advice Rule Fiduciary Exception Disclosure Requirements
1210-0154 Focus Groups for Evaluating the Effectiveness of Employee Retirement Income Security Act Section 408(b)(2) Disclosure Requirements
1210-0153 Alternative Reporting Methods for Apprenticeship and Training Plans and Top Hat Plans
1210-0152 Coverage of Certain Preventive Services Under the Affordable Care Act-For-Profit Entities
1210-0151 Focus Groups and Survey Regarding Pension Benefit Statements
1210-0150 Coverage of Certain Preventive Services under the Affordable Care Act—Private Sector
1210-0149 Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B
1210-0148 Multiple Employer Welfare Arrangement Administrative Law Judge Administrative Hearing Procedures
1210-0147 Summary of Benefits and Coverage and Uniform Glossary Required Under the Affordable Care Act
1210-0146 Request for Assistance from the Department of Labor, Employee Benefits Security Administration
1210-0145 Proposed Amendment to Prohibited Transaction Exemption 96-23 for Plan Asset Transactions Determined by In-House Asset Managers
1210-0144 Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans
1210-0143 Affordable Care Act Enrollment Opportunity Notice—Prohibition on Lifetime Limits
1210-0142 Patient Protection and Affordable Care Act Patient Protection Notice
1210-0141 Affordable Care Act Advanced Notice of Rescission
1210-0140 Affordable Care Act Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier Disclosure
1210-0139 Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage
1210-0138 Notice of Medical Necessity Criteria under the Mental Health Parity and Addition Equity Act of 2008
1210-0137 Model Employer CHIP Notice
1210-0136 Notice of Research Exception under the Genetic Information Nondiscrimination Act of 2008
1210-0135 Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction
1210-0134 Investment Advice – Participants and Beneficiaries
1210-0133 Proposed Amendment of ERISA section 408(b)(2) Regulation
1210-0132 Default Investment Alternatives under Participant Directed Individual Account Plans
1210-0131 Multiemployer Plan Access to Information
1210-0130 Statutory Exemption for Cross-Trading of Securities
1210-0129 HDCI 2 Survey of Group Health Plans
1210-0128 Proposed Amendment to PTE 84-14 for Plan Asset Transactions Determined by Independent Qualified Professional Asset Managers
1210-0127 Termination of Abandoned Individual Account Plans
1210-0126 Defined Benefit Plan Annual Funding Notice
1210-0125 ERISA Investment Manager Electronic Registration
1210-0124 Disclosures for Transactions with Trust REIT Shares
1210-0123 Notice Requirements of the Health Care Continuation Coverage Provisions
1210-0122 Notice of Blackout Period Under ERISA
1210-0121 Electronic Disclosure By Employee Benefit Plans
1210-0120 Notice of Opportunity to Enroll
1210-0119 Petition for Finding under the Employee Retirement Income Security Act Section 3(40)
1210-0118 Voluntary Fiduciary Correction Program
1210-0117 Registration for EFAST-2 Credentials
1210-0116 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
1210-0115 Proposed Class Exemption for Cross-Trades of Securities by Index and Model-Driven Funds
1210-0114 Disclosures by Insurers to General Account Policyholders
1210-0113 National Medical Support Notice-Part B
1210-0112 Furnishing Documents to the Secretary of Labor on Request Under ERISA Section 104(a)(6)
1210-0111 PTE 98-54 Relating to Certain Employee Benefit Plan Foreign Exchange Transactions Executed Pursuant to Standing Instructions
1210-0110 Form 5500 Annual Return/Report of Employee Benefit Plan
1210-0109 Survey of Form 5500 Series Filer Burden
1210-0107 Notice of Group Health Plan's Use of Transition Period and Posting Thereof
1210-0106 Calculation and Disclosure of Documentation of Eligibility for Exemption
1210-0105 Notice to Participants and Beneficiaries and the Federal Government to Electing one Percent Increased Cost Exemption
1210-0104 Prohibition Transaction Exemption 97-41
1210-0103 Establishing Creditable Coverage under Group Health Plans
1210-0102 Notice of Preexisting Condition Exclusion
1210-0101 Notice of Special Enrollment Rights under Group Health Plans
1210-0100 Regulation Relating to Definition of "Plan Assets," Participant Contributions
1210-0098 Prohibited Transaction Class Exemption 96-62; Process for Expedited Approval of an Exemption for Prohibited Transaction
1210-0097 Notice of Pension Payback Program
1210-0095 PTE 88-59 -- Residential Mortgage Financing Arrangements Involving Employee Benefit Plans
1210-0094 Prohibited Transaction Class Exemption 85-68 to Permit Employee Benefit Plans to Invest in Customer Notes of Employers
1210-0092 Prohibited Transaction Exemption 75-1- Broker-Dealers, Reporting Dealers, Banks Engaging in Securities Transactions
1210-0091 Settlement Agreements between a Plan and Party in Interest
1210-0090 Regulation Regarding Participant Directed Individual Account Plans -- ERISA Section 404(c) Plans
1210-0089 Delinquesnt Filer Voluntary Compliance Program
1210-0088 MARKET RATE ALTERNATIVE INVESTMENT CLEARINGHOUSE
1210-0087 PENSION AND HEALTH BENEFITS SUPPLEMENT TO THE SEPTEMBER 1994 CURRENT POPULATION SURVEY
1210-0086 EMPLOYEE BENEFITS SUPPLEMENT (APRIL 1993 SUPLEMENT TO THE CURRENT POPULATION SURVEY)
1210-0085 PROPOSED CLASS EXEMPTION -- CERTAIN EMPLOYEE BENEFIT PLAN FOREIGN EXCHANGE TRANSACTIONS
1210-0084 NOTICE REQUIREMENTS REGARDING TRANSFERS OF EXCESS PENSION ASSETS TO RETIREE HEALTH BENEFIT ACCOUNTS -- ERISA TECHNICAL RELEASE 91-01
1210-0083 PTE 90-1; Insurance Company Pooled Separate Accounts
1210-0082 Prohibition Transaction Exemption 91-38
1210-0081 Prohibited Transaction Exemption 77-10
1210-0080 Prohibited Transaction Exemption 78-6
1210-0079 Transactions between Individual Retirement Accounts and authorized purchasers of American Eagle Coins, Class Exemptions, PTE 91-55
1210-0078 DECEMBER 1989 RECEIPT OF PENSION BENEFITS SUPPLEMENT TO CPS
1210-0076 Regulatoin Relating to Loans to Plan Participants and to the Plan
1210-0074 Prohibited Transaction Class Exemption T88-1
1210-0073 INTERIM FINAL REGULATION REGARDING APPLICATION PROCEDURES FOR EXEMPTION FROM PROHIBITED TRANSACTIONS UNDER FERSA (SHORT TITLE - FERSA EXEMPTION PROCEDURE)
1210-0071 PROPOSED REGULATION REGARDING ALLOCATION OF FIDUCIARY RESPONSIBILITY, FEDERAL RETIREMENT THRIFT INVESTMENT BOARD
1210-0070 AUGUST 1988 CPS RETIREE HEALTH INSURANCE BENEFITS SUPPLEMENT
1210-0069 PLAN ASSETS REPORTING ALTERNATIVE REGULATION
1210-0066 ERISA Procedure 76-1; Advisory Opinion Procedure
1210-0065 Securities Lending by Employee Benefit Plans, Prohibited Transaction Exemption 2006-16
1210-0064 Sale of Securities To Reduce Indebtedness of Party in Interest—Prohibited Transaction Class Exemption 1980-83
1210-0063 Prohibited Transaction Exemption 77-8
1210-0062 Prohibited Transaction Class Exemption 82-63
1210-0061 Prohibited Transaction Exemption 81-8
1210-0060 Procedure for Applications for Exemption from the Prohibited Transaction Provisions of Section 408(a) of the Employee Retirement Income Security Act (ERISA)
1210-0059 PROPOSED CLASS EXEMPTION FOR CERTAIN TRANSACTIONS INVOLVING EMPLOYEE BENEFIT PLANS AND SECURITIES BROKER-DEALERS (REPLACING PTE 79-1 AND PTE 84-46)
1210-0058 Prohibited Transaction Class Exemptions for Multiple Employer Plans and Multiple Employer Apprenticeship Plans—PTE 1976-1, PTE 1977-10, PTE 1978-6
1210-0054 PROHIBITED TRANSACTION EXEMPTION 78-19
1210-0053 Employee Benefit Plan Claims Procedure Under the Employee Retirement Income Security Act of 1974 (ERISA)
1210-0049 Prohibited Transaction Class Exemption for Certain Transactions Between Investment Companies and Employee Benefit Plans (PTE 77-4)
1210-0048 Suspension of Pension Benefits Regulation Pursuant to 29 CFR 2530.203-3
1210-0046 LOANS TO EMPLOYEE STOCK OWNERSHIP PLANS (ESOPS) DOL REGULATION 2550.408B-3
1210-0045 PROHIBITED TRANSACTION CLASS EXEMPTION 84-24 - REPLACEMENT FOR 77-9
1210-0044 29 CFR PART 220 AIRLINE EMPLOYEE PROTECTION PROGRAM
1210-0042 1983 SURVEY OF CONSUMER FINANCES (INTERAGENCY COOPERATIVE EFFORT)
1210-0041 REGULATION RELATING TO SUPPLEMENTAL PAYMENTS
1210-0040 SUMMARY ANNUAL REPORT FURNISHED TO PARTICIPANTS AND BENEFICIARIES OF EMPLOYEE BENEFIT PLANS UNDER ERISA
1210-0039 Summary Plan Description Requirements Under the Employee Retirement Income Security Act of 1974, as Amended
1210-0037 THE MEDIATION OF GRIEVANCES IN THE COAL INDUSTRY
1210-0035 THE EFFECTIVENESS OF AREA LABOR-MANAGEMENT COMMITTEES
1210-0034 Regulation--Alternative Method of Compliance for Certain
1210-0017 SIMPLIFIED ANNUAL REPORT FORMAT
1210-0016 REVISION OF ANNUAL REPORTING REGULATIONS FOR PLANS PARTICIPATING IN A MASTER TRUST
1210-0012 TRUSTEESHIP REPORTS
1210-0011 SURETY COMPANY ANNUAL REPORT
1210-0010 ELIGIBILITY DATA FORM
1210-0009 LABOR ORGANIZATION OFFICER AND EMPLOYEE REPORT
1210-0004 EMPLOYER REPORT AND INSTRUCTIONS (EMPLOYERS DEALING WITH LAB OR ORGANIZATIONS AND UNION OFFICIALS)
1210-0001 LABOR ORGANIZATIONS AND AUXILIARY REPORT