Employee Retirement Income Security Act Summary Annual Report Requirement

Forms and Documents

Document Name	Status
1210-0040 SAR ss19 - 9-23-19.docx Supporting Statement A	2019-10-22

IC Document Collections

IC ID	Document Title	Status
13341	ERISA Summary Annual Report Requirement Other-Model Form for Welfare Plans	Modified

ICR Details

OMB Control No: 1210-0040	ICR Reference No: 201909-1210-004
Status: Historical Inactive	Previous ICR Reference No: 201902-1210-008
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Employee Retirement Income Security Act Summary Annual Report Requirement
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 12/10/2019
	Date Received in OIRA: 10/23/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2022	36 Months From Approved	06/30/2022
Responses	170,628,651	0	170,628,651
Time Burden (Hours)	1,817,006	0	1,817,006
Cost Burden (Dollars)	49,223,676	0	49,223,676

---

Abstract: Employee Retirement Income Security Act of 1974 section 104(b)(3) and regulations codified at 29 CFR 2520.104b-10 require employee benefit plans to furnish a summary of the plan's annual report to participants and specified beneficiaries for purposes of disclosure of basic financial information.

---

Authorizing Statute(s): US Code: 29 USC 1024(b)(3) Name of Law: Employee Retirement Income Security Act of 1974
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1210-AB90	Proposed rulemaking	84 FR 56894	10/23/2019

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 56894	10/23/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 56894	10/23/2019
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
ERISA Summary Annual Report Requirement

---

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 10/23/2019

---