[Federal Register Volume 72, Number 216 (Thursday, November 8, 2007)]
[Notices]
[Pages 63213-63214]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-21952]


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OFFICE OF PERSONNEL MANAGEMENT


Submission for OMB Review; Comment Request for Extension Without 
Change, of a Currently Approved 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 (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 extension without change, of a currently 
approved information collection. SF 2809, Health Benefit Election Form, 
is used by Federal employees, annuitants other than those under the 
Civil Service

[[Page 63214]]

Retirement System (CSRS) and the Federal Employees Retirement System 
(FERS) including individuals receiving benefits from the Office of 
Workers' Compensation Programs, former spouses eligible for benefits 
under the Spouse Equity Act of 1984, and separated employees and former 
dependents eligible to enroll under the Temporary Continuation of 
Coverage provisions of the FEHB law (5 U.S.C. 8905a). A different form 
(OPM 2809) is used by CSRS and FERS annuitants whose health benefit 
enrollments are administered by OPM's Retirement Services Program.
    Approximately 18,000 SF 2809 forms are completed annually. Each 
form takes approximately 30 minutes to complete. The annual estimated 
burden is 9,000 hours.
    For copies of this proposal, contact Mary Beth Smith-Toomey on 
(202) 606-8358, Fax (202) 418-3251 or via E-mail to [email protected]. 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--Jay Fritz, Insurance Services 
Program, Center for Retirement and Insurance Services, U.S. Office of 
Personnel Management, 1900 E Street, NW., Room 3415, Washington, DC 
20415; and Brenda Aguilar, OPM Desk Officer, Office of Information & 
Regulatory Affairs, Office of Management and Budget, New Executive 
Office Building, NW., Room 10235, Washington, DC 20503.
    For Information Regarding Administrative Coordination--Contact: 
Cyrus S. Benson, Team Leader, Publications Team, RIS Support Services/
Support Group, (202) 606-0623.

    U.S. Office of Personnel Management.
Howard Weizmann,
Deputy Director.
[FR Doc. E7-21952 Filed 11-7-07; 8:45 am]
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