10720 Federal Register / Vol. 80, No. 39 / Friday, February 27, 2015 / Notices 

Department of Labor-OASAM, Office of 

the Chief Information Officer, Attn: 

Departmental Information Compliance 

Management Program, Room N1301, 

200 Constitution Avenue NW., 

Washington, DC 20210; or by email: 

DOL_PRA_PUBLIC@dol.gov. 

FOR FURTHER INFORMATION CONTACT: 

Contact Michel Smyth by telephone at 

202–693–4129, TTY 202–693–8064, 

(these are not toll-free numbers) or by 

email at DOL_PRA_PUBLIC@dol.gov. 

Authority: 44 U.S.C. 3507(a)(1)(D). 

SUPPLEMENTARY INFORMATION: This ICR 

seeks to extend PRA authority for the 

‘‘Coverage of Certain Preventive 

Services Under the Affordable Care Act’’ 

information collection. The information 

collection requires any plan established 

or maintained by certain religious 

employers (and group health insurance 

coverage provided in connection with 

such a plan) claiming exemption to 

providing contraceptive service to selfcertify that it meets the definition of an 

eligible organization. The eligible 

organization provides its health 

insurance issuer or third-party 

administrator with a copy of the selfcertification. A third-party administrator 

arranging or providing payments for 

contraceptive services at no cost to 

participants and beneficiaries in insured 

or self-insured plans (or student 

enrollees and covered dependents in 

student health insurance coverage) of an 

eligible organization is to provide a 

written notice to plan participants and 

beneficiaries (or such student enrollees 

and covered dependents) informing 

them of the availability of such 

payments. The notice must be provided 

contemporaneous with (to the extent 

possible) but separate from plan 

enrollment (or re-enrollment) materials, 

and must specify that contraceptive 

coverage will not be provided by the 

eligible organization but that the thirdparty administrator will separately 

arrange or provide payments for 

contraceptive services. The notice must 

also provide contact information for the 

third-party administrator for questions 

and complaints. To satisfy the notice 

requirement, a third-party administrator 

may use the model language set forth in 

the final regulations or substantially 

similar language. Form EBSA–700, 

Eligible Organization Self-Certification, 

may be used to make the certification to 

the insurer. Interim final regulations 

issued in 2014 provide for an alternative 

notification to the Federal government 

when an eligible organization has a 

religious objection to providing 

contraceptive coverage that still 

preserves participants’ and 

beneficiaries’ access to coverage for the 

full range of Food and Drug 

Administration approved 

contraceptives, as prescribed by a health 

care provider, without cost sharing. 

Employee Retirement Income Security 

Act of 1974 section 307 authorizes this 

collection. See 29 U.S.C. 1185b. 

This information collection is subject 

to the PRA. A Federal agency generally 

cannot conduct or sponsor a collection 

of information, and the public is 

generally not required to respond to an 

information collection, unless it is 

approved by the OMB under the PRA 

and displays a currently valid OMB 

Control Number. In addition, 

notwithstanding any other provisions of 

law, no person shall generally be subject 

to penalty for failing to comply with a 

collection of information that does not 

display a valid Control Number. See 5 

CFR 1320.5(a) and 1320.6. The DOL 

obtains OMB approval for this 

information collection under Control 

Number 1210–0150. 

OMB authorization for an ICR cannot 

be for more than three (3) years without 

renewal, and the current approval for 

this collection is scheduled to expire on 

February 28, 2015. The DOL seeks to 

extend PRA authorization for this 

information collection for three (3) more 

years, without any change to existing 

requirements. The DOL notes that 

existing information collection 

requirements submitted to the OMB 

receive a month-to-month extension 

while they undergo review. For 

additional substantive information 

about this ICR, see the related notice 

published in the Federal Register on 

December 11, 2014 (79 FR 73629). 

Interested parties are encouraged to 

send comments to the OMB, Office of 

Information and Regulatory Affairs at 

the address shown in the ADDRESSES

section within thirty (30) days of 

publication of this notice in the Federal 

Register. In order to help ensure 

appropriate consideration, comments 

should mention OMB Control Number 

1210–0150. The OMB is particularly 

interested in comments that: 

• Evaluate whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information will have 

practical utility; 

• Evaluate the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; 

• Enhance the quality, utility, and 

clarity of the information to be 

collected; and 

• Minimize the burden of the 

collection of information on those who 

are to respond, including through the 

use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology, 

e.g., permitting electronic submission of 

responses. 

Agency: DOL–EBSA. 

Title of Collection: Coverage of 

Certain Preventive Services Under the 

Affordable Care Act. 

OMB Control Number: 1210–0150. 

Affected Public: Private Sector— 

businesses or other for-profits and notfor-profit institutions. 

Total Estimated Number of 

Respondents: 61. 

Total Estimated Number of 

Responses: 61. 

Total Estimated Annual Time Burden: 

51 hours. 

Total Estimated Annual Other Costs 

Burden: $33. 

Dated: February 23, 2015. 

Michel Smyth, 

Departmental Clearance Officer. 

[FR Doc. 2015–04095 Filed 2–26–15; 8:45 am] 

BILLING CODE 4510–29–P 

DEPARTMENT OF LABOR 

Office of the Secretary 

Agency Information Collection 

Activities; Submission for OMB 

Review; Comment Request; Notice of 

Final Payment or Suspension of 

Compensation Benefits 

ACTION: Notice. 

SUMMARY: The Department of Labor 

(DOL) is submitting the Office of 

Workers’ Compensation Programs 

(OWCP) sponsored information 

collection request (ICR) revision titled, 

‘‘Notice of Final Payment or Suspension 

of Compensation Benefits,’’ to the Office 

of Management and Budget (OMB) for 

review and approval for use in 

accordance with the Paperwork 

Reduction Act (PRA) of 1995 (44 U.S.C. 

3501 et seq.). Public comments on the 

ICR are invited. 

DATES: The OMB will consider all 

written comments that agency receives 

on or before March 30, 2015. 

ADDRESSES: A copy of this ICR with 

applicable supporting documentation; 

including a description of the likely 

respondents, proposed frequency of 

response, and estimated total burden 

may be obtained free of charge from the 

RegInfo.gov Web site at http://

www.reginfo.gov/public/do/

PRAViewICR?ref_nbr=201411-1240-003 

(this link will only become active on the 

day following publication of this notice) 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 80, No. 39 / Friday, February 27, 2015 / Notices 10721 

or by contacting Michel Smyth by 

telephone at 202–693–4129, TTY 202– 

693–8064, (these are not toll-free 

numbers) or sending an email to DOL_

PRA_PUBLIC@dol.gov. 

Submit comments about this request 

by mail or courier to the Office of 

Information and Regulatory Affairs, 

Attn: OMB Desk Officer for DOL– 

OWCP, Office of Management and 

Budget, Room 10235, 725 17th Street 

NW., Washington, DC 20503; by Fax: 

202–395–5806 (this is not a toll-free 

number); or by email: OIRA_

submission@omb.eop.gov. Commenters 

are encouraged, but not required, to 

send a courtesy copy of any comments 

by mail or courier to the U.S. 

Department of Labor-OASAM, Office of 

the Chief Information Officer, Attn: 

Departmental Information Compliance 

Management Program, Room N1301, 

200 Constitution Avenue NW., 

Washington, DC 20210; or by email: 

DOL_PRA_PUBLIC@dol.gov. 

FOR FURTHER INFORMATION CONTACT: 

Michel Smyth by telephone at 202–693– 

4129, TTY 202–693–8064, (these are not 

toll-free numbers) or sending an email 

to DOL_PRA_PUBLIC@dol.gov. 

Authority: 44 U.S.C. 3507(a)(1)(D). 

SUPPLEMENTARY INFORMATION: This ICR 

seeks approval under the PRA for 

revisions to the Notice of Final Payment 

or Suspension of Compensation Benefits 

information collection. The Notice of 

Final Payment or Suspension of 

Compensation Benefits, Form LS–208, is 

used by insurance carriers and selfinsured employers to report the 

payment of benefits under the 

Longshore and Harbors Workers 

Compensation Act. This information 

collection has been classified as a 

revision, because the Department has 

made cosmetic changes to the Form LS– 

208, such as expanding the size and 

types of boxes used for responding. 

These changes are not expected to 

change the public burden. Longshore 

and Harbor Workers’ Compensation Act 

section 914(g) authorizes this collection. 

See 33 U.S.C. 914(g). 

This information collection is subject 

to the PRA. A Federal agency generally 

cannot conduct or sponsor a collection 

of information, and the public is 

generally not required to respond to an 

information collection, unless it is 

approved by the OMB under the PRA 

and displays a currently valid OMB 

Control Number. In addition, 

notwithstanding any other provisions of 

law, no person shall generally be subject 

to penalty for failing to comply with a 

collection of information that does not 

display a valid Control Number. See 5 

CFR 1320.5(a) and 1320.6. The DOL 

obtains OMB approval for this 

information collection under Control 

Number 1240–0041. The current 

approval is scheduled to expire on 

February 28, 2015; however, the DOL 

notes that existing information 

collection requirements submitted to the 

OMB receive a month-to-month 

extension while they undergo review. 

New requirements would only take 

effect upon OMB approval. For 

additional substantive information 

about this ICR, see the related notice 

published in the Federal Register on 

December 1, 2014 (79 FR 71130). 

Interested parties are encouraged to 

send comments to the OMB, Office of 

Information and Regulatory Affairs at 

the address shown in the ADDRESSES

section within thirty (30) days of 

publication of this notice in the Federal 

Register. In order to help ensure 

appropriate consideration, comments 

should mention OMB Control Number 

1240–0041. The OMB is particularly 

interested in comments that: 

• Evaluate whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information will have 

practical utility; 

• Evaluate the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information, 

including the validity of the 

methodology and assumptions used; 

• Enhance the quality, utility, and 

clarity of the information to be 

collected; and 

• Minimize the burden of the 

collection of information on those who 

are to respond, including through the 

use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology, 

e.g., permitting electronic submission of 

responses. 

Agency: DOL–OWCP. 

Title of Collection: Notice of Final 

Payment or Suspension of 

Compensation Benefits. 

OMB Control Number: 1240–0041. 

Affected Public: Private Sector— 

Businesses or other for-profits. 

Total Estimated Number of 

Respondents: 600. 

Total Estimated Number of 

Responses: 21,000. 

Total Estimated Annual Time Burden: 

5,250 hours. 

Total Estimated Annual Other Costs 

Burden: $10,920. 

Dated: February 23, 2015. 

Michel Smyth, 

Departmental Clearance Officer. 

[FR Doc. 2015–04078 Filed 2–26–15; 8:45 am] 

BILLING CODE 4510–CF–P 

DEPARTMENT OF LABOR 

Employment and Training 

Administration 

Notice To Ensure State Workforce 

Agencies Are Aware of the Revised 

Schedule of Remuneration for the 

Unemployment Compensation for ExServicemembers (UCX) Program That 

Reflects the Military Pay Increase 

Effective January 1, 2015 

AGENCY: Employment and Training 

Administration, Labor. 

ACTION: Notice. 

SUMMARY: Each year, the Department of 

Defense issues a Schedule of 

Remuneration that may be used by 

states, as needed, for UCX purposes. 

States must use the schedule to 

determine Federal military wages for 

UCX ‘‘first claims’’ only when the 

Federal Claims Control Center (FCCC) 

responds to a request for information 

indicating that there is no Copy 5 of the 

Certificate of Release or Discharge from 

Active Duty (DD Form 214) for an 

individual under the social security 

number provided. A response from the 

FCCC that indicates ‘‘no DD214 on file’’ 

will prompt the state to start the 

affidavit process and to use the attached 

schedule to calculate the Federal 

military wages for an unemployment 

insurance or UCX monetary 

determination. 

The schedule applies to UCX ‘‘first 

claims’’ filed beginning with the first 

day of the first week that begins on or 

after January 1, 2015, pursuant to the 

UCX program regulations (see 20 CFR 

614.12(c)). States must continue to use 

the existing schedule for UCX ‘‘first 

claims’’ filed before the effective date of 

the revised schedule. 

Portia Wu, 

Assistant Secretary for Employment and 

Training, Labor. 

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