FED VIP (BENFEDS.com)

Federal Employees Dental and Vision Insurance Program (FEDVIP)

Documents and Forms

Document Name Document Type
FED VIP (BENFEDS.com) Form and Instruction
Federal Employees Dental and Vision Insurance Program En FEDVIP Screenshots.docx BENEFEDS.GOV Form and Instruction

Information Collection (IC) Details

IC Title:	FED VIP (BENFEDS.com)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR Chapter 89 A 5 CFR Chapter 89B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Federal Employees Dental and Vision Insurance Program Enrollment System	FEDVIP Screenshots.docx	BENEFEDS.GOV	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: OPM/Central-1, Civil Service Retirement and Insurance Records	FR Citation: 82 FR 32191

Number of Respondents: 502,347	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	502,347	170,043	332,304
Annual IC Time Burden (Hours)	58,858	14,551	44,307
Annual IC Cost Burden (Dollars)	2,088,759	1,929,771	158,988

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.