HEALTH PLAN NOTICES To see if any other states have added a premium assistance program, or for Paperwork Reduction Act Statement more information on special enrollment rights, contact either: According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no U.S. Department of Labor persons are required to respond to a collection of information unless such Employee Benefits Security Administration collection displays a valid Office of Management and Budget (OMB) control www.dol.gov/agencies/ebsa number. The Department notes that a Federal agency cannot conduct or 1-866-444-EBSA (3272) sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is U.S. Department of Health and Human Services not required to respond to a collection of information unless it displays a Centers for Medicare & Medicaid Services currently valid OMB control number. See 44 U.S.C. 3507. Also, www.cms.hhs.gov notwithstanding any other provisions of law, no person shall be subject to 1-877-267-2323, Menu Option 4, Ext. 61565 penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately four minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W ., Room N-5718, Washington, DC 20210 or email and reference the OMB Control Number 1210- 0137. [email protected]