80_FR_55428 80 FR 55250 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select; TRICARE Dental Program; Early Eligibility for TRICARE for Certain Reserve Component Members

80 FR 55250 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select; TRICARE Dental Program; Early Eligibility for TRICARE for Certain Reserve Component Members

DEPARTMENT OF DEFENSE
Office of the Secretary

Federal Register Volume 80, Issue 178 (September 15, 2015)

Page Range55250-55256
FR Document2015-22815

TRICARE Reserve Select (TRS) is a premium-based TRICARE health plan available for purchase worldwide by qualified members of the Ready Reserve and by qualified survivors of TRS members. TRICARE Dental Program (TDP) is a premium-based TRICARE dental plan available for purchase worldwide by qualified Service members. This final rule revises requirements and procedures for the TRS program to specify the appropriate actuarial basis for calculating premiums in addition to making other minor clarifying administrative changes. For a member who is involuntarily separated from the Selected Reserve under other than adverse conditions this final rule provides a time-limited exception that allows TRS coverage in effect to continue for up to 180 days after the date on which the member is separated from the Selected Reserve and TDP coverage in effect to continue for no less than 180 days after the separation date. It also expands early TRICARE eligibility for certain Reserve Component members from a maximum of 90 days to a maximum of 180 days prior to activation in support of a contingency operation for more than 30 days.

Federal Register, Volume 80 Issue 178 (Tuesday, September 15, 2015)
[Federal Register Volume 80, Number 178 (Tuesday, September 15, 2015)]
[Rules and Regulations]
[Pages 55250-55256]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-22815]


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DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

[DOD-2006-HA-0207]
RIN 0720-AB15


Civilian Health and Medical Program of the Uniformed Services 
(CHAMPUS); TRICARE Reserve Select; TRICARE Dental Program; Early 
Eligibility for TRICARE for Certain Reserve Component Members

AGENCY: Office of the Secretary, DoD.

ACTION: Final rule.

-----------------------------------------------------------------------

SUMMARY: TRICARE Reserve Select (TRS) is a premium-based TRICARE health 
plan available for purchase worldwide by qualified members of the Ready 
Reserve and by qualified survivors of TRS members. TRICARE Dental 
Program (TDP) is a premium-based TRICARE dental plan available for 
purchase worldwide by qualified Service members. This final rule 
revises requirements and procedures for the TRS program to specify the 
appropriate actuarial basis for calculating premiums in addition to 
making other minor clarifying administrative changes. For a member who 
is involuntarily separated from the Selected Reserve under other than 
adverse conditions this final rule provides a time-limited exception 
that allows TRS coverage in effect to continue for up to 180 days after 
the date on which the member is separated from the Selected Reserve and 
TDP coverage in effect to continue for no less than 180 days after the 
separation date. It also expands early TRICARE eligibility for certain 
Reserve Component members from a maximum of 90 days to a maximum of 180 
days prior to activation in support of a contingency operation for more 
than 30 days.

DATES: This rule is effective October 15, 2015.

FOR FURTHER INFORMATION CONTACT: Brian Smith, Defense Health Agency, 
TRICARE Health Plan Division, telephone (703) 681-0039.
    Questions regarding payment of specific claims under the TRICARE 
allowable charge method should be addressed to the appropriate TRICARE 
contractor.

SUPPLEMENTARY INFORMATION:

I. Introduction and Background

A. Overview

    An interim final rule was published in the Federal Register on 
August 20, 2007 (72 FR 46380). That interim final rule addressed 
provisions of the National Defense Authorization Act for Fiscal Year 
2007 (NDAA-07) (Pub. L. 109-364),which expanded eligibility for the 
TRICARE Reserve Select program to include all Selected Reservists 
except those individuals either enrolled or

[[Page 55251]]

eligible to enroll in the Federal Employees Health Benefits program.
    Before finalizing the interim final rule, a proposed rule was 
published in the Federal Register on August 27, 2014 (79 FR 51127). The 
proposed rule addressed provisions of the National Defense 
Authorization Act for Fiscal Year 2009 (NDAA-09) (Pub. L. 110-417), the 
National Defense Authorization Act for Fiscal Year 2010 (NDAA-10) (Pub. 
L. 111-84), and the National Defense Authorization Act for Fiscal Year 
2013 (NDAA-13) (Pub. L. 112-239). First, section 704 of NDAA-09 
specifies that the appropriate actuarial basis for calculating premiums 
for TRS shall utilize the actual cost of providing benefits to members 
and their dependents during preceding calendar years. Second, section 
702 of NDAA-10 expands early eligibility for Reserve Component members 
issued delayed-effective-date active duty orders from a maximum of 90 
days to a maximum of 180 days prior to activation in support of a 
contingency for more than 30 days. Third, for a member who is 
involuntarily separated from the Selected Reserve under other than 
adverse conditions as characterized by the Secretary concerned, section 
701 of NDAA-13 provides a time-limited exception that allows TRS 
coverage already in effect at time of separation to continue for up to 
180 days after the date on which the member is separated from the 
Selected Reserve and TDP coverage already in effect at time of 
separation to continue for no less than 180 days after the separation 
date. This exception expires December 31, 2018. Finally, the proposed 
rule addressed additional administrative clarifications to 32 CFR 
199.24, which implements TRS.
    This final rule addresses and finalizes the provisions in both the 
interim final rule and the proposed rule.

B. Public Comments

    An interim final rule was published in the Federal Register on 
August 20, 2007 and we received 4 comments (one comment was a duplicate 
submission). A proposed rule was published in the Federal Register on 
August 27, 2014 and we received 1 comment. We thank those who provided 
comments. Specific matters raised by those who submitted comments are 
summarized below.

II. Provisions of the Rule Regarding Early TRICARE Eligibility

    1. Provisions of Proposed Rule. Section 199.3(b)(5) implements 
section 702 of NDAA-10, which specifies that Reserve Component members 
issued delayed-effective-date orders for service in support of a 
contingency operation, and their family members, are eligible for 
TRICARE on the date the orders are issued, up to a maximum of 180 days 
prior to the date on which the period of active duty of more than 30 
consecutive days is to begin. Previously, members and their family 
members could become eligible for TRICARE up to a maximum of 90 days 
prior to the date on which the period of active duty in support of a 
contingency operation of more than 30 consecutive days is to begin.
    2. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    3. Provisions of the Final Rule. The final rule is consistent with 
the proposed rule.

III. Provisions of the Rule Regarding the TRICARE Dental Program

    A summary of the relevant proposed rule provision is presented, 
followed by an analysis of major public comments, and by a summary of 
the final rule provisions.
    1. Provisions of Proposed Final Rule. So that the existing 
provisions of Sec.  199.13(c)(3)(ii)(E)(2) would not be confused with 
the new paragraph described below, we proposed to clarify that the 
continued coverage described in this paragraph is actually survivor 
coverage. We also proposed to reinsert the provision that the 
government will pay both the government and the beneficiary's portion 
of the premium share during the three-year period of continued survivor 
enrollment, which was inadvertently deleted by a previous amendment to 
the regulation.
    We proposed to add new Sec.  199.13(c)(3)(ii)(E)(5) that implements 
the provisions in section 701 of NDAA- 13 concerning TDP. A time-
limited exception is added to the general rule that TDP coverage shall 
terminate for members who no longer qualify for TDP. This exception 
specifies that if a member is involuntarily separated from the Selected 
Reserve under other than adverse conditions, as characterized by the 
Secretary concerned, and TDP coverage was in effect for the member and/
or the family on the last day of his or her membership in the Selected 
Reserve, the TDP coverage that was in effect, whether member coverage 
and/or family coverage, may terminate no earlier than 180 days after 
the date on which the member is separated from the Selected Reserve. 
This exception expires December 31, 2018.
    2. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    3. Provisions of the Final Rule. The final rule is consistent with 
the proposed rule.

IV. Provisions of the Rule Regarding the TRICARE Reserve Select Program

    Many of our proposed clarifications update the rules for TRS (Sec.  
199.24) and, as appropriate, bring the rules in closer alignment and 
sequencing with the very similar TRICARE Retired Reserve program (Sec.  
199.25).

A. Establishment of the TRICARE Reserve Select Program (Sec.  
199.24(a))

    1. Provisions of Interim Final Rule. This paragraph describes the 
nature, purpose, statutory basis, scope, and major features of TRICARE 
Reserve Select, a premium-based medical coverage program that was made 
available worldwide to certain members of the Selected Reserve and 
their family members. TRICARE Reserve Select is authorized by 10 U.S.C. 
1076d.
    2. Provisions of the Proposed Rule. We proposed to remove the 
existing terminology at Sec.  199.24(a)(4) and to redesignate Sec.  
199.24(a)(5) as Sec.  199.24(a)(4). We proposed to clarify that certain 
special programs established in 32 CFR part 199 are not available to 
members covered under TRS (Sec.  199.24(a)(4)(i)(B)).
    We proposed to clarify the wording for submitting an initial 
payment of the appropriate premium along with the request to purchase 
coverage (Sec.  199.24(a)(4)(iii)) and to make it consistent throughout 
this section. We proposed to clarify that both the member and the 
member's covered family members are provided access priority for care 
in military treatment facilities on the same basis as active duty 
service members' dependents who are not enrolled in TRICARE Prime 
(Sec.  199.24(a)(4)(iv)).
    3. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    4. Provisions of the Final Rule. The final rule is consistent with 
the interim final rule and the proposed rule.

B. Qualifications for TRICARE Reserve Select Coverage (Sec.  199.24(b))

    1. Provisions of Interim Final Rule. In the interim final rule, 
paragraph (b) addressed TRICARE Reserve Select premiums (Sec.  
199.24(b)). It continued that members are charged premiums for coverage 
under TRICARE Reserve Select that represent 28 percent of the total 
annual premium amount that the Assistant Secretary of Defense, Health 
Affairs (ASD(HA)) determines on an appropriate actuarial basis as being

[[Page 55252]]

appropriate for coverage under the TRICARE Standard (and Extra) benefit 
for the TRICARE Reserve Select eligible population. Premiums are to be 
paid monthly, except as otherwise established as part of the 
administrative implementation of TRICARE Reserve Select.
    Annual rates for the first year TRICARE Reserve Select was offered 
(2005) were based on the calendar year annual premiums for the Blue 
Cross and Blue Shield Standard Service Benefit Plan under the Federal 
Employees Health Benefits Program, a nationwide plan closely resembling 
TRICARE Standard (and Extra) coverage, with an adjustment based on 
estimated differences in covered populations, as determined by the 
ASD(HA).
    Based on an analysis of demographic differences between Blue Cross 
and Blue Shield members and beneficiaries eligible for TRICARE Reserve 
Select, the adjustment amount in calendar year 2005 represented a 32 
percent reduction from the Blue Cross and Blue Shield annual premium 
for member-only coverage and represented an 8 percent reduction from 
the Blue Cross and Blue Shield annual premium for member and family 
coverage. (The difference in the percentage reductions between member 
only and member and family premiums is due to the disproportionately 
high number of high cost, single, elderly retiree federal employees 
covered by Blue Cross and Blue Shield member-only coverage).
    TRICARE Reserve Select monthly premium rates are established and 
updated annually, on a calendar year basis, to maintain an appropriate 
relationship with the annual changes in Blue Cross and Blue Shield 
premiums, or by other adjustment methodology determined to be 
appropriate by the ASD(HA) for each of the two types of coverage, 
member-only coverage and member and family coverage, on a calendar year 
basis. The monthly rate for each month of a calendar year is one 
twelfth of the annual rate for that calendar year.
    In addition to these annual premium changes, premium adjustments 
may also be made prospectively for any calendar year to reflect any 
significant program changes or any actual experience in the costs of 
administering the TRICARE Reserve Select Program.
    A surviving family member of a Reserve Component service member who 
qualified for TRICARE Reserve Select coverage as described in paragraph 
(c)(3) of this section will pay premium rates as follows. The premium 
amount shall be at the member-only rate if there is only one surviving 
family member to be covered by TRICARE Reserve Select and at the member 
and family rate if there are two or more survivors to be covered.
    2. Provisions of the Proposed Rule. We proposed to redesignate 
Sec.  199.24(c) as Sec.  199.24(b) so that it precedes the section on 
TRICARE Reserve Select premiums for clarity and maintains parallel 
sequencing with Sec.  199.25.
    Section 10144(b) of title 10, U.S.C. provides that the Secretary 
concerned may designate a category of members within the Individual 
Ready Reserve (IRR) of each Reserve Component who are subject to being 
ordered to active duty involuntarily in accordance with section 12304 
of title 10, U.S.C. We proposed to clarify that since a member of the 
IRR who has volunteered to serve in such mobilization category is 
eligible for benefits (other than pay and training) as are normally 
available to members of the Selected Reserve, these members may also 
qualify for TRS (Sec.  199.24(b)(1)(i)).
    We proposed to clarify the exclusion involving the Federal 
Employees Health Benefits (FEHB) program. Section 199.24(b)(1)(ii) 
specifies that an otherwise qualified member of the Ready Reserve 
qualifies to purchase TRS coverage if the member is not enrolled in, or 
eligible to enroll in, a health benefits plan under chapter 89 of title 
5, U.S.C. That statute has been implemented under part 890 of title 5, 
CFR as the ``Federal Employees Health Benefits'' program. For purposes 
of the FEHB program, the terms ``enrolled,'' ``enroll'' and 
``enrollee'' are defined in Sec.  890.101 of title 5, CFR. We proposed 
to clarify that the member (or certain involuntarily separated former 
member) no longer qualifies for TRS coverage when the member has been 
eligible for active coverage in a health benefits plan under the FEHB 
program for more than 60 days (Sec.  199.24(b)(1)(ii)). This affords 
the member sufficient time to make arrangements for health coverage 
other than TRS and avoid any days without having health coverage being 
in force.
    We proposed to clarify that qualification for TRS survivor coverage 
applies regardless of type of coverage in effect on the day of the TRS 
member's death (Sec.  199.24(b)(2)).
    3. Analysis of Major Public Comments. One commenter suggested that 
we eliminate the exclusion regarding the FEHB program rather than 
clarify it.
    Response. The exclusion is statutory; the Department of Defense has 
no authority to eliminate it.
    4. Provisions of the Final Rule. Note in the proposed rule that we 
proposed to redesignate paragraph (c) as paragraph (b) so that the 
section on Qualifications for TRICARE Reserve Select coverage would 
precede the section on TRICARE Reserve Select premiums for clarity 
purposes and to maintain consistent sequencing with Sec.  199.25. Then 
we proposed to replace the content in the section on Eligibility for 
(qualifying to purchase) TRICARE Reserve Select coverage that appeared 
in the interim final rule in its entirety with the newly revised 
section on Qualifications for TRICARE Reserve Select coverage. 
Therefore, the final rule is consistent with the proposed rule.

C. TRICARE Reserve Select Premiums (Sec.  199.24(c))

    1. Provisions of Interim Final Rule. In the interim final rule, 
Sec.  199.24(c) addressed Eligibility for (qualifying to purchase) 
TRICARE Reserve Select coverage. It reflected the statutory conditions 
under which members of a Reserve component may qualify to purchase 
TRICARE Reserve Select coverage.
    2. Provisions of the Proposed Rule. We proposed to redesignate 
Sec.  199.24(b) as Sec.  199.24(c) so that it follows the section on 
Qualifications for TRICARE Reserve Select coverage for clarity purposes 
and maintains consistent sequencing with Sec.  199.25. We also proposed 
to clarify that the Director, Healthcare Operations in the Defense 
Health Agency may establish procedures for administrative 
implementation related to premiums (Sec.  199.24(c)).
    Section 199.24(c)(1) implements section 704 of NDAA-09, which 
requires that monthly premiums be determined by utilizing the actual 
reported cost of providing benefits to TRS members and their dependents 
during preceding calendar years. Section 704 of NDAA-09 specified that 
actual TRS cost data from calendar years 2006 and 2007 be utilized in 
the determination of premium rates for calendar year 2009. This 
established pattern has been followed to determine premium rates for 
all calendar years starting with 2009 (Sec.  199.24(c)(1)). Further, we 
proposed to amend Sec.  199.24(c) by deleting all former provisions 
involving the relationship between premium rates for TRS and premium 
rates for the Blue Cross and Blue Shield Standard Service Benefit Plan 
under the Federal Employees Health Benefits program.
    3. Analysis of Major Public Comments. Three military service 
organizations commented on the methodology described in the interim 
final rule to be used for annual TRS premium updates that was based on

[[Page 55253]]

annual changes in premiums in the Blue Cross/Blue Shield plan offered 
nationwide by the Federal Employees Health Benefits program. Rather 
than applying the same percentage increases to TRS premiums that were 
observed in the federal Blue Cross/Blue Shield nationwide plan, each 
commenting organization requested that the annual TRS premium increases 
not exceed the percentage increase in military basic pay.
    Response. Section 704 of NDAA-09 added 10 U.S.C. 1076 d(d)(3)(B) to 
specify that the appropriate actuarial basis for calculating premiums 
for TRS shall utilize the actual cost of providing benefits to members 
and their dependents during preceding calendar years. The final rule is 
consistent with this statutory requirement.
    4. Provisions of the Final Rule. Note in the proposed rule that we 
proposed to redesignate paragraph (b) as paragraph (c) so that the 
section on TRICARE Reserve Select premiums would follow the section on 
Qualifications for TRICARE Reserve Select coverage for clarity purposes 
and to maintain consistent sequencing with Sec.  199.25). Then we 
proposed to replace the content on TRICARE Reserve Select premiums that 
appeared in the interim final rule in its entirety with the newly 
revised section on TRICARE Reserve Select premiums in order to 
implement section 704 of NDAA-09. That had the effect of removing all 
of the former provisions involving the relationship between premium 
rates for TRS and premium rates for the Blue Cross and Blue Shield 
Standard Service Benefit Plan under the Federal Employees Health 
Benefits program will appear in the amended Sec.  199.24(c). The final 
rule is consistent with the proposed rule.

D. Procedures (Sec.  199.24(d))

1. Provisions of Interim Final Rule
    The interim final rule addressed procedures for TRS coverage.
    2. Provisions of the Proposed Rule. We proposed to clarify that the 
Director, Healthcare Operations in the Defense Health Agency may 
establish procedures for TRS (Sec.  199.24(d)).
    We proposed to clarify that either reserve members or survivors 
qualified under Sec.  199.24(b) may follow applicable procedures 
throughout this section regarding TRS coverage. We proposed to clarify 
the rule about immediate family members who may be included in family 
coverage under TRS (Sec.  199.24(d)(1)), which is further supported by 
the proposed definition for immediate family member included in Sec.  
199.24(g).
    We proposed to clarify continuation coverage by removing the 
previous requirement that the member had to be the sponsor of the other 
TRICARE coverage in order to qualify for continuation coverage (Sec.  
199.24(d)(1)(i)). In circumstances when the spouse of the Reserve 
Component member is the sponsor for purposes of the other TRICARE 
coverage, it would be clear that the qualified member would be able to 
purchase TRS coverage with an effective date immediately following the 
date of termination of coverage under another TRICARE program 
regardless whether it was the Reserve Component member or the spouse 
who was the sponsor of the other TRICARE coverage.
    We proposed rules to implement the provisions in section 701 of 
NDAA-13 concerning TRS coverage (Sec.  199.24(d)(3)(i)). Similar to the 
TDP, this provision would apply to members involuntarily separated from 
the Selected Reserve if, and only if, the member was covered by TRS on 
the last day of his or her membership in the Selected Reserve. However, 
the termination date of TRS is characterized slightly differently from 
the TDP provision because TRS may terminate up to 180 days after the 
date on which the member is separated from the Selected Reserve. This 
delayed termination exception applies regardless of type of TRS 
coverage actually in effect at the time. This exception expires 
December 31, 2018.
    We proposed to clarify the rule that procedures may be established 
for TRS coverage to be suspended for up to one year followed by final 
termination for members or qualified survivors if they fail to make 
premium payments in accordance with established procedures or otherwise 
if they request suspension/termination of coverage (Sec.  
199.24(d)(3)). Suspension/termination of coverage for the TRS member/
survivor will result in suspension/termination of coverage for the 
member's/survivor's family members in TRS, except as described in Sec.  
199.24 (d)(1)(iv). We also proposed to clarify that procedures may be 
established for the suspension to be lifted upon request before final 
termination is applied.
    3. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    4. Provisions of the Final Rule. The final rule is consistent with 
the interim final rule and the proposed rule.

E. Preemption of State Laws (Sec.  199.24(e))

    1. Provisions of Interim Final Rule. In the interim final rule, 
paragraph (e) addressed Relationship to Continued Health Care Benefits 
Program (CHCBP) (Sec.  199.24(e)). Based on a statutory amendment 
concerning CHCBP, the Final Rule published September 16, 2011 (76 FR 
57637-57641) removed paragraph (e) in its entirety and replaced it with 
the placeholder (e) Reserved to maintain numerical sequencing.
    3. Provisions of the Proposed Rule. We proposed to remove the 
previous Sec.  199.24(e) Reserved and redesignate Sec.  199.24(f) as 
Sec.  199.24(e). No other changes are proposed this section.
    4. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    5. Provisions of the Final Rule. The final rule is consistent with 
the proposed rule.

F. Administration (Sec.  199.25(f))

    1. Provisions of Interim Final Rule. In the interim final rule, 
paragraph (f) addressed Preemption of State laws (Sec.  199.25(f)).
    2. Provisions of the Proposed Rule. We proposed to redesignate 
Sec.  199.24(g) as Sec.  199.24(f). We proposed to clarify this 
provision by removing the phrase, ``based on extraordinary 
circumstances'' as a limitation on authority to grant exceptions to 
requirements of the section and to clarify that the Director, 
Healthcare Operations in the Defense Health Agency has authority to 
grant such exceptions and establish administrative rules and procedures 
for TRS.
    3. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    4. Provisions of the Final Rule. The final rule is consistent with 
the proposed rule.

G. Terminology (Sec.  199.25(g))

    1. Provisions of Interim Final Rule. In the interim final rule, 
paragraph (g) addressed Administration (Sec.  199.25(g)).
    2. Provisions of the Proposed Rule. We proposed to redesignate 
paragraph (g) as paragraph (f) and to add a new paragraph (g) regarding 
terminology. This would also remove the terminology under Sec.  
199.25(a)(4).
    3. Analysis of Major Public Comments. No public comments were 
received relating to this section of the rule.
    4. Provisions of the Final Rule. The final rule is consistent with 
the proposed rule.

V. Costs

    Fiscal year 2014 through 2019 costs are anticipated to be 
$7,735,728.00:

[[Page 55254]]



------------------------------------------------------------------------
                                                            Government
                       Fiscal year                             cost
------------------------------------------------------------------------
2014....................................................      $1,296,884
2015....................................................       1,373,929
2016....................................................       1,455,633
2017....................................................       1,542,277
2018....................................................       1,634,096
2019....................................................         432,909
                                                         ---------------
  Total FY14-FY19.......................................       7,735,728
------------------------------------------------------------------------

VI. Regulatory Procedures

    Executive Orders 12866 and 13563 require certain regulatory 
assessments for any significant regulatory action that would result in 
an annual effect on the economy of $100 million or more, or have other 
substantial impacts. The Congressional Review Act establishes certain 
procedures for major rules, defined as those with similar major 
impacts. The Regulatory Flexibility Act (RFA) requires that each 
Federal agency prepare, and make available for public comment, a 
regulatory flexibility analysis when the agency issues a regulation 
that would have significant impact on a substantial number of small 
entities. This final rule is not subject to any of these requirements 
because it will not have any of these substantial impacts. However, 
this rule has been designated a ``significant regulatory action,'' 
although not economically significant, under section 3(f) of Executive 
Order 12866. Accordingly, the rule has been reviewed by the Office of 
Management and Budget (OMB).
    This rule will not impose additional information collection 
requirements on the public under the Paperwork Reduction Act of 1995 
(44 U.S.C. 3501-3511).
    We have examined the impact(s) of the final rule under Executive 
Order 13132 and it does not have policies that have federalism 
implications that will have substantial direct effects on the States, 
on the relationship between the national government and the States, or 
on the distribution of power and responsibilities among the various 
levels of government. The preemption provisions in the rule conform to 
law and long-established TRICARE policy. Therefore, consultation with 
State and local officials is not required.

List of Subjects in 32 CFR Part 199

    Claims, Handicapped, Health insurance, Military personnel.

    Accordingly, the interim final rule published at 72 FR 46380 on 
August 20, 2007, amending 32 CFR part 199 is adopted as a final rule 
with the following changes:

PART 199--[AMENDED]

0
1. The authority citation for part 199 continues to read as follows:


    Authority:  5 U.S.C. 301; 10 U.S.C. chapter 55.

0
2. Amend Sec.  199.3 by revising paragraph (b)(5)(iii)(B) to read as 
follows:


Sec.  199.3  Eligibility.

* * * * *
    (b) * * *
    (5) * * *
    (iii) * * *
    (B) 180 days before the date on which the period of active duty is 
to begin.
* * * * *

0
3. Amend Sec.  199.13 by revising paragraph (c)(3)(ii)(E)(2) 
introductory text and adding paragraph (c)(3)(ii)(E)(5) to read as 
follows:


Sec.  199.13  TRICARE Dental Program.

* * * * *
    (c) * * *
    (3) * * *
    (ii) * * *
    (E) * * *
    (2) Survivor eligibility. Eligible dependents of active duty 
members who die while on active duty for a period of more than 30 days 
and eligible dependents of members of the Ready Reserve (i.e., Selected 
Reserve or Individual Ready Reserve, as specified in 10 U.S.C. 10143 
and 10144(b) respectively) who die, shall be eligible for survivor 
enrollment in the TDP. During the period of survivor enrollment, the 
government will pay both the government and the eligible dependent's 
portion of the premium share. This survivor enrollment shall be up to 
(3) three years from the date of the member's death, except that, in 
the case of a dependent of the deceased who is described in 10 U.S.C. 
1072(2)(D) or (I), the period of survivor enrollment shall be the 
longer of the following periods beginning on the date of the member's 
death:
* * * * *
    (5) TRICARE Dental Program coverage shall terminate for members who 
no longer qualify for the TRICARE Dental Program as specified in 
paragraph (c)(2) of this section, with one exception. If a member is 
involuntarily separated from the Selected Reserve under other than 
adverse conditions, as characterized by the Secretary concerned, and 
TRICARE Dental Program coverage is in effect for the member and/or the 
family on the last day of his or her membership in the Selected 
Reserve; then the TRICARE Dental Program coverage that was actually in 
effect may terminate no earlier than 180 days after the date on which 
the member is separated from the Selected Reserve. This exception 
expires December 31, 2018.
* * * * *

0
4. Amend Sec.  199.24 as follows.
0
a. Remove paragraph (a)(4).
0
b. Redesignate paragraph (a)(5) as paragraph (a)(4).
0
c. Revise newly redesignated paragraphs (a)(4)(i)(B), (a)(4)(iii), and 
(a)(4)(iv).
0
d. Redesignate paragraphs (b) and (c) as paragraphs (c) and (b), 
respectively.
0
e. Revise newly redesignated paragraphs (b) and (c).
0
f. Revise paragraph (d).
0
g. Redesignate paragraphs (f) and (g) as paragraphs (e) and (f), 
respectively.
0
h. Revise newly redesignated paragraph (f).
0
i. Add new paragraph (g).
    The revisions and additions read as follows:


Sec.  199.24  TRICARE Reserve Select.

    (a) * * *
    (4) * * *
    (i) * * *
    (B) Certain special programs established in 32 CFR part 199 are not 
available to members covered under TRICARE Reserve Select. These 
include the Extended Care Health Option (Sec.  199.5), the Special 
Supplemental Food Program (see Sec.  199.23), and the Supplemental 
Health Care Program (Sec.  199.16), except when referred by a Military 
Treatment Facility (MTF) provider for incidental consults and the MTF 
provider maintains clinical control over the episode of care. The 
TRICARE Dental Program (Sec.  199.13) is independent of this program 
and is otherwise available to all members of the Selected Reserve and 
their eligible family members whether or not they purchase TRICARE 
Reserve Select coverage. The Continued Health Care Benefits Program 
(Sec.  199.20) is also independent of this program and is otherwise 
available to all members who qualify.
* * * * *
    (iii) Procedures. Under TRICARE Reserve Select, Reserve Component 
members who fulfilled all of the statutory qualifications may purchase 
either the member-only type of coverage or the member-and-family type 
of coverage by submitting a completed request in the appropriate format 
along with an initial payment of the applicable premium. Rules and 
procedures for purchasing coverage and paying applicable premiums are 
prescribed in this section.
    (iv) Benefits. When their coverage becomes effective, TRICARE 
Reserve

[[Page 55255]]

Select beneficiaries receive the TRICARE Standard (and Extra) benefit 
including access to military treatment facility services and 
pharmacies, as described in Sec. Sec.  199.17 and 199.21. TRICARE 
Reserve Select coverage features the deductible and cost share 
provisions of the TRICARE Standard (and Extra) plan applicable to 
active duty family members for both the member and the member's covered 
family members (paragraph (a)(4)(iv) of this section). Both the member 
and the member's covered family members are provided access priority 
for care in military treatment facilities on the same basis as active 
duty service members' dependents who are not enrolled in TRICARE Prime 
as described in Sec.  199.17(d)(1)(i)(D).
    (b) Qualifications for TRICARE Reserve Select coverage--(1) Ready 
Reserve member. A Ready Reserve member qualifies to purchase TRICARE 
Reserve Select coverage if the Service member meets both the following 
criteria:
    (i) Is a member of the Selected Reserve of the Ready Reserve of the 
Armed Forces, or a member of the Individual Ready Reserve of the Armed 
Forces who has volunteered to be ordered to active duty pursuant to the 
provisions of 10 U.S.C. 12304 in accordance with section 10 U.S.C. 
10144(b); and
    (ii) Is not enrolled in, or eligible to enroll in, a health 
benefits plan under 5 U.S.C. chapter 89. That statute has been 
implemented under 5 CFR part 890 as the Federal Employees Health 
Benefits (FEHB) program. For purposes of the FEHB program, the terms 
``enrolled,'' ``enroll'' and ``enrollee'' are defined in 5 CFR 890.101. 
Further, the member (or certain former member involuntarily separated) 
no longer qualifies for TRICARE Reserve Select when the member (or 
former member) has been eligible for coverage to be effective in a 
health benefits plan under the FEHB program for more than 60 days.
    (2) TRICARE Reserve Select survivor. If a qualified Service member 
dies while in a period of TRICARE Reserve Select coverage, the 
immediate family member(s) of such member is qualified to purchase new 
or continue existing TRICARE Reserve Select coverage for up to six 
months beyond the date of the member's death as long as they meet the 
definition of immediate family members as specified in paragraph (g)(2) 
of this section. This applies regardless of type of coverage in effect 
on the day of the TRICARE Reserve Select member's death.
    (c) TRICARE Reserve Select premiums. Members are charged premiums 
for coverage under TRICARE Reserve Select that represent 28 percent of 
the total annual premium amount that the Director, Defense Health 
Agency determines on an appropriate actuarial basis as being 
appropriate for coverage under the TRICARE Standard (and Extra) benefit 
for the TRICARE Reserve Select eligible population. Premiums are to be 
paid monthly, except as otherwise provided through administrative 
implementation, pursuant to procedures established by the Director, 
Healthcare Operations in the Defense Health Agency. The monthly rate 
for each month of a calendar year is one-twelfth of the annual rate for 
that calendar year.
    (1) Annual establishment of rates. TRICARE Reserve Select monthly 
premium rates shall be established and updated annually on a calendar 
year basis for each of the two types of coverage, member-only and 
member- and-family as described in paragraph (d)(1) of this section. 
Starting with calendar year 2009, the appropriate actuarial basis for 
purposes of this paragraph (c) shall be determined for each calendar 
year by utilizing the actual reported cost of providing benefits under 
this section to members and their dependents during the calendar years 
preceding such calendar year. Reported actual TRS cost data from 
calendar years 2006 and 2007 was used to determine premium rates for 
calendar year 2009. This established pattern will be followed to 
determine premium rates for all calendar years subsequent to 2009.
    (2) Premium adjustments. In addition to the determinations 
described in paragraph (c)(1) of this section, premium adjustments may 
be made prospectively for any calendar year to reflect any significant 
program changes or any actual experience in the costs of administering 
TRICARE Reserve Select.
    (3) Survivor premiums. A surviving family member of a Reserve 
Component service member who qualified for TRICARE Reserve Select 
coverage as described in paragraph (b)(2) of this section will pay 
premium rates as follows. The premium amount shall be at the member-
only rate if there is only one surviving family member to be covered by 
TRICARE Reserve Select and at the member and family rate if there are 
two or more survivors to be covered.
    (d) Procedures. The Director, Healthcare Operations in the Defense 
Health Agency, may establish procedures for the following.
    (1) Purchasing coverage. Procedures may be established for a 
qualified member to purchase one of two types of coverage: Member-only 
coverage or member and family coverage. Immediate family members of a 
qualified member as specified in paragraph (g)(2) of this section may 
be included in such family coverage. To purchase either type of TRICARE 
Reserve Select coverage for effective dates of coverage described 
below, members and survivors qualified under either paragraph (b)(1) or 
(2) of this section must submit a request in the appropriate format, 
along with an initial payment of the applicable premium required by 
paragraph (c) of this section in accordance with established 
procedures.
    (i) Continuation coverage. Procedures may be established for a 
qualified member or qualified survivor to purchase TRICARE Reserve 
Select coverage with an effective date immediately following the date 
of termination of coverage under another TRICARE program.
    (ii) Qualifying life event. Procedures may be established for a 
qualified member or qualified survivor to purchase TRICARE Reserve 
Select coverage on the occasion of a qualifying life event that changes 
the immediate family composition (e.g., birth, adoption, divorce, etc.) 
that is eligible for coverage under TRICARE Reserve Select. The 
effective date for TRICARE Reserve Select coverage will coincide with 
the date of the qualifying life event. It is the responsibility of the 
member to provide personnel officials with the necessary evidence 
required to substantiate the change in immediate family composition. 
Personnel officials will update DEERS in the usual manner. Appropriate 
action will be taken upon receipt of the completed request in the 
appropriate format along with an initial payment of the applicable 
premium in accordance with established procedures.
    (iii) Open enrollment. Procedures may be established for a 
qualified member to purchase TRICARE Reserve Select coverage at any 
time. The effective date of coverage will coincide with the first day 
of a month.
    (iv) Survivor coverage under TRICARE Reserve Select. Procedures may 
be established for a surviving family member of a Reserve Component 
service member who qualified for TRICARE Reserve Select coverage as 
described in paragraph (b)(2) of this section to purchase new TRICARE 
Reserve Select coverage or continue existing TRICARE Reserve Select 
coverage for up to six months beyond the date of the member's death. 
The effective date of coverage will be the day following the date of 
the member's death.

[[Page 55256]]

    (2) Changing type of coverage. Procedures may be established for 
TRICARE Reserve Select members to request to change type of coverage 
during open enrollment as described in paragraph (d)(1)(iii) of this 
section or on the occasion of a qualifying life event that changes 
immediate family composition as described in paragraph (d)(1)(ii) of 
this section by submitting a completed request in the appropriate 
format.
    (3) Suspension and termination. Suspension/termination of coverage 
for the TRS member/survivor will result in suspension/termination of 
coverage for the member's/survivor's family members in TRICARE Reserve 
Select, except as described in paragraph (d)(1)(iv) of this section. 
Procedures may be established for coverage to be suspended or 
terminated as follows.
    (i) Coverage shall terminate when members or survivors no longer 
qualify for TRICARE Reserve Select as specified in paragraph (b) of 
this section, with one exception. If a member is involuntarily 
separated from the Selected Reserve under other than adverse 
conditions, as characterized by the Secretary concerned, and is covered 
by TRICARE Reserve Select on the last day of his or her membership in 
the Selected Reserve, then TRICARE Reserve Select coverage may 
terminate up to 180 days after the date on which the member was 
separated from the Selected Reserve. This applies regardless of type of 
coverage. This exception expires December 31, 2018.
    (ii) Coverage may terminate for members, former members, and 
survivors who gain coverage under another TRICARE program.
    (iii) Coverage may be suspended and finally terminated for members/
survivors who fail to make premium payments in accordance with 
established procedures.
    (iv) Coverage may be suspended and finally terminated for members/
survivors upon request at any time by submitting a completed request in 
the appropriate format in accordance with established procedures.
    (v) Under paragraph (d)(3)(iii) or (iv) of this section, TRICARE 
Reserve Select coverage may first be suspended for a period of up to 
one year followed by final termination. Procedures may be established 
for the suspension to be lifted upon request before final termination 
is applied.
    (4) Processing. Upon receipt of a completed request in the 
appropriate format, enrollment actions will be processed into DEERS in 
accordance with established procedures.
    (5) Periodic revision. Periodically, certain features, rules or 
procedures of TRICARE Reserve Select may be revised. If such revisions 
will have a significant effect on members' or survivors' costs or 
access to care, members or survivors may be given the opportunity to 
change their type of coverage or terminate coverage coincident with the 
revisions.
* * * * *
    (f) Administration. The Director, Healthcare Operations in the 
Defense Health Agency may establish other rules and procedures for the 
effective administration of TRICARE Reserve Select, and may authorize 
exceptions to requirements of this section, if permitted by law.
    (g) Terminology. The following terms are applicable to the TRICARE 
Reserve Select program.
    (1) Coverage. This term means the medical benefits covered under 
the TRICARE Standard or Extra programs as further outlined in other 
sections of 32 CFR part 199 whether delivered in military treatment 
facilities or purchased from civilian sources.
    (2) Immediate family member. This term means spouse (except former 
spouses) as defined in Sec.  199.3(b)(2)(i), or child as defined in 
Sec.  199.3(b)(2)(ii).
    (3) Qualified member. This term means a member who has satisfied 
all the criteria that must be met before the member is authorized for 
TRS coverage.
    (4) Qualified survivor. This term means an immediate family member 
who has satisfied all the criteria that must be met before the survivor 
is authorized for TRS coverage.

    Dated: September 4, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2015-22815 Filed 9-14-15; 8:45 am]
 BILLING CODE 5001-06-P



                                                55250            Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations

                                                                       For plans with a valuation                                                                            Deferred annuities
                                                                                                                Immediate
                                                                                 date                                                                                            (percent)
                                                    Rate set                                                   annuity rate
                                                                                                                 (percent)
                                                                      On or after             Before                                          i1                   i2                   i3                    n1                n2


                                                            *                         *                           *                            *                         *                            *                     *
                                                      264               10–1–15             11–1–15                   1.25                   4.00                 4.00                 4.00                   7                  8



                                                ■ 3. In appendix C to part 4022, Rate Set                     Appendix C to Part 4022—Lump Sum
                                                264, as set forth below, is added to the                      Interest Rates for Private-Sector
                                                table.                                                        Payments
                                                                                                              *        *      *          *         *

                                                                       For plans with a valuation                                                                            Deferred annuities
                                                                                                                Immediate
                                                                                 date                                                                                            (percent)
                                                    Rate set                                                   annuity rate
                                                                                                                 (percent)
                                                                      On or after             Before                                          i1                   i2                   i3                    n1                n2


                                                            *                         *                           *                            *                         *                            *                     *
                                                      264               10–1–15             11–1–15                   1.25                   4.00                 4.00                 4.00                   7                  8



                                                PART 4044—ALLOCATION OF                                         Authority: 29 U.S.C. 1301(a), 1302(b)(3),                          Appendix B to Part 4044—Interest
                                                ASSETS IN SINGLE-EMPLOYER                                     1341, 1344, 1362.                                                    Rates Used to Value Benefits
                                                PLANS                                                                                                                              *       *      *       *        *
                                                                                                              ■ 5. In appendix B to part 4044, a new
                                                ■ 4. The authority citation for part 4044                     entry for October–December 2015, as set
                                                continues to read as follows:                                 forth below, is added to the table.

                                                                                                                                                                         The values of it are:
                                                         For valuation dates occurring in the month—
                                                                                                                                    it                  for t =               it                for t =                it       for t =


                                                        *                   *                                 *                          *                               *                            *                      *
                                                October–December 2015 .....................................................         0.0246                     1–20          0.0298                    >20    N/A           N/A



                                                  Issued in Washington, DC, on this 10th day                  health plan available for purchase                                   contingency operation for more than 30
                                                of September 2015.                                            worldwide by qualified members of the                                days.
                                                Judith Starr,                                                 Ready Reserve and by qualified                                       DATES:      This rule is effective October 15,
                                                General Counsel, Pension Benefit Guaranty                     survivors of TRS members. TRICARE                                    2015.
                                                Corporation.                                                  Dental Program (TDP) is a premium-
                                                [FR Doc. 2015–23231 Filed 9–14–15; 8:45 am]                                                                                        FOR FURTHER INFORMATION CONTACT:
                                                                                                              based TRICARE dental plan available
                                                                                                                                                                                   Brian Smith, Defense Health Agency,
                                                BILLING CODE 7709–02–P                                        for purchase worldwide by qualified
                                                                                                                                                                                   TRICARE Health Plan Division,
                                                                                                              Service members. This final rule revises
                                                                                                                                                                                   telephone (703) 681–0039.
                                                                                                              requirements and procedures for the
                                                DEPARTMENT OF DEFENSE                                                                                                                 Questions regarding payment of
                                                                                                              TRS program to specify the appropriate
                                                                                                                                                                                   specific claims under the TRICARE
                                                                                                              actuarial basis for calculating premiums
                                                Office of the Secretary                                                                                                            allowable charge method should be
                                                                                                              in addition to making other minor
                                                                                                                                                                                   addressed to the appropriate TRICARE
                                                                                                              clarifying administrative changes. For a                             contractor.
                                                32 CFR Part 199
                                                                                                              member who is involuntarily separated
                                                [DOD–2006–HA–0207]                                            from the Selected Reserve under other                                SUPPLEMENTARY INFORMATION:
                                                RIN 0720–AB15                                                 than adverse conditions this final rule                              I. Introduction and Background
                                                                                                              provides a time-limited exception that
                                                Civilian Health and Medical Program of                        allows TRS coverage in effect to                                     A. Overview
                                                the Uniformed Services (CHAMPUS);                             continue for up to 180 days after the                                  An interim final rule was published
                                                TRICARE Reserve Select; TRICARE                               date on which the member is separated                                in the Federal Register on August 20,
                                                Dental Program; Early Eligibility for                         from the Selected Reserve and TDP                                    2007 (72 FR 46380). That interim final
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                                                TRICARE for Certain Reserve                                   coverage in effect to continue for no less                           rule addressed provisions of the
                                                Component Members                                             than 180 days after the separation date.                             National Defense Authorization Act for
                                                AGENCY:      Office of the Secretary, DoD.                    It also expands early TRICARE                                        Fiscal Year 2007 (NDAA–07) (Pub. L.
                                                ACTION:     Final rule.                                       eligibility for certain Reserve                                      109–364),which expanded eligibility for
                                                                                                              Component members from a maximum                                     the TRICARE Reserve Select program to
                                                SUMMARY:   TRICARE Reserve Select                             of 90 days to a maximum of 180 days                                  include all Selected Reservists except
                                                (TRS) is a premium-based TRICARE                              prior to activation in support of a                                  those individuals either enrolled or


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                                                                 Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations                                      55251

                                                eligible to enroll in the Federal                       in support of a contingency operation,                   3. Provisions of the Final Rule. The
                                                Employees Health Benefits program.                      and their family members, are eligible                final rule is consistent with the
                                                   Before finalizing the interim final                  for TRICARE on the date the orders are                proposed rule.
                                                rule, a proposed rule was published in                  issued, up to a maximum of 180 days
                                                the Federal Register on August 27, 2014                                                                       IV. Provisions of the Rule Regarding the
                                                                                                        prior to the date on which the period of
                                                (79 FR 51127). The proposed rule                                                                              TRICARE Reserve Select Program
                                                                                                        active duty of more than 30 consecutive
                                                addressed provisions of the National                    days is to begin. Previously, members                    Many of our proposed clarifications
                                                Defense Authorization Act for Fiscal                    and their family members could become                 update the rules for TRS (§ 199.24) and,
                                                Year 2009 (NDAA–09) (Pub. L. 110–                       eligible for TRICARE up to a maximum                  as appropriate, bring the rules in closer
                                                417), the National Defense                              of 90 days prior to the date on which the             alignment and sequencing with the very
                                                Authorization Act for Fiscal Year 2010                  period of active duty in support of a                 similar TRICARE Retired Reserve
                                                (NDAA–10) (Pub. L. 111–84), and the                     contingency operation of more than 30                 program (§ 199.25).
                                                National Defense Authorization Act for                  consecutive days is to begin.                         A. Establishment of the TRICARE
                                                Fiscal Year 2013 (NDAA–13) (Pub. L.                        2. Analysis of Major Public
                                                                                                                                                              Reserve Select Program (§ 199.24(a))
                                                112–239). First, section 704 of NDAA–                   Comments. No public comments were
                                                09 specifies that the appropriate                       received relating to this section of the                 1. Provisions of Interim Final Rule.
                                                actuarial basis for calculating premiums                rule.                                                 This paragraph describes the nature,
                                                for TRS shall utilize the actual cost of                   3. Provisions of the Final Rule. The               purpose, statutory basis, scope, and
                                                providing benefits to members and their                 final rule is consistent with the                     major features of TRICARE Reserve
                                                dependents during preceding calendar                    proposed rule.                                        Select, a premium-based medical
                                                years. Second, section 702 of NDAA–10                                                                         coverage program that was made
                                                                                                        III. Provisions of the Rule Regarding
                                                expands early eligibility for Reserve                                                                         available worldwide to certain members
                                                                                                        the TRICARE Dental Program
                                                Component members issued delayed-                                                                             of the Selected Reserve and their family
                                                effective-date active duty orders from a                   A summary of the relevant proposed                 members. TRICARE Reserve Select is
                                                maximum of 90 days to a maximum of                      rule provision is presented, followed by              authorized by 10 U.S.C. 1076d.
                                                180 days prior to activation in support                 an analysis of major public comments,                    2. Provisions of the Proposed Rule.
                                                of a contingency for more than 30 days.                 and by a summary of the final rule                    We proposed to remove the existing
                                                Third, for a member who is                              provisions.                                           terminology at § 199.24(a)(4) and to
                                                involuntarily separated from the                           1. Provisions of Proposed Final Rule.              redesignate § 199.24(a)(5) as
                                                Selected Reserve under other than                       So that the existing provisions of                    § 199.24(a)(4). We proposed to clarify
                                                adverse conditions as characterized by                  § 199.13(c)(3)(ii)(E)(2) would not be                 that certain special programs
                                                the Secretary concerned, section 701 of                 confused with the new paragraph                       established in 32 CFR part 199 are not
                                                NDAA–13 provides a time-limited                         described below, we proposed to clarify               available to members covered under
                                                exception that allows TRS coverage                      that the continued coverage described in              TRS (§ 199.24(a)(4)(i)(B)).
                                                already in effect at time of separation to              this paragraph is actually survivor                      We proposed to clarify the wording
                                                continue for up to 180 days after the                   coverage. We also proposed to reinsert                for submitting an initial payment of the
                                                date on which the member is separated                   the provision that the government will                appropriate premium along with the
                                                from the Selected Reserve and TDP                       pay both the government and the                       request to purchase coverage
                                                coverage already in effect at time of                   beneficiary’s portion of the premium                  (§ 199.24(a)(4)(iii)) and to make it
                                                separation to continue for no less than                 share during the three-year period of                 consistent throughout this section. We
                                                180 days after the separation date. This                continued survivor enrollment, which                  proposed to clarify that both the
                                                exception expires December 31, 2018.                    was inadvertently deleted by a previous               member and the member’s covered
                                                Finally, the proposed rule addressed                    amendment to the regulation.                          family members are provided access
                                                additional administrative clarifications                   We proposed to add new                             priority for care in military treatment
                                                to 32 CFR 199.24, which implements                      § 199.13(c)(3)(ii)(E)(5) that implements              facilities on the same basis as active
                                                TRS.                                                    the provisions in section 701 of NDAA–                duty service members’ dependents who
                                                   This final rule addresses and finalizes              13 concerning TDP. A time-limited                     are not enrolled in TRICARE Prime
                                                the provisions in both the interim final                exception is added to the general rule                (§ 199.24(a)(4)(iv)).
                                                rule and the proposed rule.                             that TDP coverage shall terminate for                    3. Analysis of Major Public
                                                                                                        members who no longer qualify for TDP.                Comments. No public comments were
                                                B. Public Comments                                      This exception specifies that if a                    received relating to this section of the
                                                  An interim final rule was published                   member is involuntarily separated from                rule.
                                                in the Federal Register on August 20,                   the Selected Reserve under other than                    4. Provisions of the Final Rule. The
                                                2007 and we received 4 comments (one                    adverse conditions, as characterized by               final rule is consistent with the interim
                                                comment was a duplicate submission).                    the Secretary concerned, and TDP                      final rule and the proposed rule.
                                                A proposed rule was published in the                    coverage was in effect for the member
                                                                                                        and/or the family on the last day of his              B. Qualifications for TRICARE Reserve
                                                Federal Register on August 27, 2014
                                                                                                        or her membership in the Selected                     Select Coverage (§ 199.24(b))
                                                and we received 1 comment. We thank
                                                those who provided comments. Specific                   Reserve, the TDP coverage that was in                   1. Provisions of Interim Final Rule. In
                                                matters raised by those who submitted                   effect, whether member coverage and/or                the interim final rule, paragraph (b)
                                                comments are summarized below.                          family coverage, may terminate no                     addressed TRICARE Reserve Select
                                                                                                        earlier than 180 days after the date on               premiums (§ 199.24(b)). It continued
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                                                II. Provisions of the Rule Regarding                    which the member is separated from the                that members are charged premiums for
                                                Early TRICARE Eligibility                               Selected Reserve. This exception                      coverage under TRICARE Reserve Select
                                                   1. Provisions of Proposed Rule.                      expires December 31, 2018.                            that represent 28 percent of the total
                                                Section 199.3(b)(5) implements section                     2. Analysis of Major Public                        annual premium amount that the
                                                702 of NDAA–10, which specifies that                    Comments. No public comments were                     Assistant Secretary of Defense, Health
                                                Reserve Component members issued                        received relating to this section of the              Affairs (ASD(HA)) determines on an
                                                delayed-effective-date orders for service               rule.                                                 appropriate actuarial basis as being


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                                                55252            Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations

                                                appropriate for coverage under the                      member to be covered by TRICARE                       paragraph (b) so that the section on
                                                TRICARE Standard (and Extra) benefit                    Reserve Select and at the member and                  Qualifications for TRICARE Reserve
                                                for the TRICARE Reserve Select eligible                 family rate if there are two or more                  Select coverage would precede the
                                                population. Premiums are to be paid                     survivors to be covered.                              section on TRICARE Reserve Select
                                                monthly, except as otherwise                               2. Provisions of the Proposed Rule.                premiums for clarity purposes and to
                                                established as part of the administrative               We proposed to redesignate § 199.24(c)                maintain consistent sequencing with
                                                implementation of TRICARE Reserve                       as § 199.24(b) so that it precedes the                § 199.25. Then we proposed to replace
                                                Select.                                                 section on TRICARE Reserve Select                     the content in the section on Eligibility
                                                   Annual rates for the first year                      premiums for clarity and maintains                    for (qualifying to purchase) TRICARE
                                                TRICARE Reserve Select was offered                      parallel sequencing with § 199.25.                    Reserve Select coverage that appeared in
                                                (2005) were based on the calendar year                     Section 10144(b) of title 10, U.S.C.               the interim final rule in its entirety with
                                                annual premiums for the Blue Cross and                  provides that the Secretary concerned                 the newly revised section on
                                                Blue Shield Standard Service Benefit                    may designate a category of members                   Qualifications for TRICARE Reserve
                                                Plan under the Federal Employees                        within the Individual Ready Reserve                   Select coverage. Therefore, the final rule
                                                Health Benefits Program, a nationwide                   (IRR) of each Reserve Component who                   is consistent with the proposed rule.
                                                plan closely resembling TRICARE                         are subject to being ordered to active
                                                Standard (and Extra) coverage, with an                  duty involuntarily in accordance with                 C. TRICARE Reserve Select Premiums
                                                adjustment based on estimated                           section 12304 of title 10, U.S.C. We                  (§ 199.24(c))
                                                differences in covered populations, as                  proposed to clarify that since a member                  1. Provisions of Interim Final Rule. In
                                                determined by the ASD(HA).                              of the IRR who has volunteered to serve               the interim final rule, § 199.24(c)
                                                   Based on an analysis of demographic                  in such mobilization category is eligible             addressed Eligibility for (qualifying to
                                                differences between Blue Cross and                      for benefits (other than pay and training)            purchase) TRICARE Reserve Select
                                                Blue Shield members and beneficiaries                   as are normally available to members of               coverage. It reflected the statutory
                                                eligible for TRICARE Reserve Select, the                the Selected Reserve, these members                   conditions under which members of a
                                                adjustment amount in calendar year                      may also qualify for TRS                              Reserve component may qualify to
                                                2005 represented a 32 percent reduction                 (§ 199.24(b)(1)(i)).                                  purchase TRICARE Reserve Select
                                                from the Blue Cross and Blue Shield                        We proposed to clarify the exclusion               coverage.
                                                annual premium for member-only                          involving the Federal Employees Health                   2. Provisions of the Proposed Rule.
                                                coverage and represented an 8 percent                   Benefits (FEHB) program. Section                      We proposed to redesignate § 199.24(b)
                                                reduction from the Blue Cross and Blue                  199.24(b)(1)(ii) specifies that an                    as § 199.24(c) so that it follows the
                                                Shield annual premium for member and                    otherwise qualified member of the                     section on Qualifications for TRICARE
                                                family coverage. (The difference in the                 Ready Reserve qualifies to purchase                   Reserve Select coverage for clarity
                                                percentage reductions between member                    TRS coverage if the member is not                     purposes and maintains consistent
                                                only and member and family premiums                     enrolled in, or eligible to enroll in, a              sequencing with § 199.25. We also
                                                is due to the disproportionately high                   health benefits plan under chapter 89 of              proposed to clarify that the Director,
                                                number of high cost, single, elderly                    title 5, U.S.C. That statute has been                 Healthcare Operations in the Defense
                                                retiree federal employees covered by                    implemented under part 890 of title 5,                Health Agency may establish
                                                Blue Cross and Blue Shield member-                      CFR as the ‘‘Federal Employees Health                 procedures for administrative
                                                only coverage).                                         Benefits’’ program. For purposes of the               implementation related to premiums
                                                   TRICARE Reserve Select monthly                       FEHB program, the terms ‘‘enrolled,’’                 (§ 199.24(c)).
                                                premium rates are established and                       ‘‘enroll’’ and ‘‘enrollee’’ are defined in               Section 199.24(c)(1) implements
                                                updated annually, on a calendar year                    § 890.101 of title 5, CFR. We proposed                section 704 of NDAA–09, which
                                                basis, to maintain an appropriate                       to clarify that the member (or certain                requires that monthly premiums be
                                                relationship with the annual changes in                 involuntarily separated former member)                determined by utilizing the actual
                                                Blue Cross and Blue Shield premiums,                    no longer qualifies for TRS coverage                  reported cost of providing benefits to
                                                or by other adjustment methodology                      when the member has been eligible for                 TRS members and their dependents
                                                determined to be appropriate by the                     active coverage in a health benefits plan             during preceding calendar years.
                                                ASD(HA) for each of the two types of                    under the FEHB program for more than                  Section 704 of NDAA–09 specified that
                                                coverage, member-only coverage and                      60 days (§ 199.24(b)(1)(ii)). This affords            actual TRS cost data from calendar years
                                                member and family coverage, on a                        the member sufficient time to make                    2006 and 2007 be utilized in the
                                                calendar year basis. The monthly rate                   arrangements for health coverage other                determination of premium rates for
                                                for each month of a calendar year is one                than TRS and avoid any days without                   calendar year 2009. This established
                                                twelfth of the annual rate for that                     having health coverage being in force.                pattern has been followed to determine
                                                calendar year.                                             We proposed to clarify that                        premium rates for all calendar years
                                                   In addition to these annual premium                  qualification for TRS survivor coverage               starting with 2009 (§ 199.24(c)(1)).
                                                changes, premium adjustments may also                   applies regardless of type of coverage in             Further, we proposed to amend
                                                be made prospectively for any calendar                  effect on the day of the TRS member’s                 § 199.24(c) by deleting all former
                                                year to reflect any significant program                 death (§ 199.24(b)(2)).                               provisions involving the relationship
                                                changes or any actual experience in the                    3. Analysis of Major Public                        between premium rates for TRS and
                                                costs of administering the TRICARE                      Comments. One commenter suggested                     premium rates for the Blue Cross and
                                                Reserve Select Program.                                 that we eliminate the exclusion                       Blue Shield Standard Service Benefit
                                                   A surviving family member of a                       regarding the FEHB program rather than                Plan under the Federal Employees
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                                                Reserve Component service member                        clarify it.                                           Health Benefits program.
                                                who qualified for TRICARE Reserve                          Response. The exclusion is statutory;                 3. Analysis of Major Public
                                                Select coverage as described in                         the Department of Defense has no                      Comments. Three military service
                                                paragraph (c)(3) of this section will pay               authority to eliminate it.                            organizations commented on the
                                                premium rates as follows. The premium                      4. Provisions of the Final Rule. Note              methodology described in the interim
                                                amount shall be at the member-only rate                 in the proposed rule that we proposed                 final rule to be used for annual TRS
                                                if there is only one surviving family                   to redesignate paragraph (c) as                       premium updates that was based on


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                                                                 Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations                                      55253

                                                annual changes in premiums in the Blue                     We proposed to clarify continuation                addressed Relationship to Continued
                                                Cross/Blue Shield plan offered                          coverage by removing the previous                     Health Care Benefits Program (CHCBP)
                                                nationwide by the Federal Employees                     requirement that the member had to be                 (§ 199.24(e)). Based on a statutory
                                                Health Benefits program. Rather than                    the sponsor of the other TRICARE                      amendment concerning CHCBP, the
                                                applying the same percentage increases                  coverage in order to qualify for                      Final Rule published September 16,
                                                to TRS premiums that were observed in                   continuation coverage (§ 199.24(d)(1)(i)).            2011 (76 FR 57637–57641) removed
                                                the federal Blue Cross/Blue Shield                      In circumstances when the spouse of the               paragraph (e) in its entirety and
                                                nationwide plan, each commenting                        Reserve Component member is the                       replaced it with the placeholder (e)
                                                organization requested that the annual                  sponsor for purposes of the other                     Reserved to maintain numerical
                                                TRS premium increases not exceed the                    TRICARE coverage, it would be clear                   sequencing.
                                                percentage increase in military basic                   that the qualified member would be able                  3. Provisions of the Proposed Rule.
                                                pay.                                                    to purchase TRS coverage with an                      We proposed to remove the previous
                                                   Response. Section 704 of NDAA–09                     effective date immediately following the              § 199.24(e) Reserved and redesignate
                                                added 10 U.S.C. 1076 d(d)(3)(B) to                      date of termination of coverage under                 § 199.24(f) as § 199.24(e). No other
                                                specify that the appropriate actuarial                  another TRICARE program regardless                    changes are proposed this section.
                                                basis for calculating premiums for TRS                  whether it was the Reserve Component                     4. Analysis of Major Public
                                                shall utilize the actual cost of providing              member or the spouse who was the                      Comments. No public comments were
                                                benefits to members and their                           sponsor of the other TRICARE coverage.                received relating to this section of the
                                                dependents during preceding calendar                       We proposed rules to implement the                 rule.
                                                years. The final rule is consistent with                provisions in section 701 of NDAA–13                     5. Provisions of the Final Rule. The
                                                this statutory requirement.                             concerning TRS coverage                               final rule is consistent with the
                                                   4. Provisions of the Final Rule. Note                (§ 199.24(d)(3)(i)). Similar to the TDP,              proposed rule.
                                                in the proposed rule that we proposed                   this provision would apply to members                 F. Administration (§ 199.25(f))
                                                to redesignate paragraph (b) as                         involuntarily separated from the
                                                                                                        Selected Reserve if, and only if, the                    1. Provisions of Interim Final Rule. In
                                                paragraph (c) so that the section on                                                                          the interim final rule, paragraph (f)
                                                TRICARE Reserve Select premiums                         member was covered by TRS on the last
                                                                                                        day of his or her membership in the                   addressed Preemption of State laws
                                                would follow the section on                                                                                   (§ 199.25(f)).
                                                Qualifications for TRICARE Reserve                      Selected Reserve. However, the
                                                                                                        termination date of TRS is characterized                 2. Provisions of the Proposed Rule.
                                                Select coverage for clarity purposes and                                                                      We proposed to redesignate § 199.24(g)
                                                to maintain consistent sequencing with                  slightly differently from the TDP
                                                                                                        provision because TRS may terminate                   as § 199.24(f). We proposed to clarify
                                                § 199.25). Then we proposed to replace                                                                        this provision by removing the phrase,
                                                the content on TRICARE Reserve Select                   up to 180 days after the date on which
                                                                                                        the member is separated from the                      ‘‘based on extraordinary circumstances’’
                                                premiums that appeared in the interim                                                                         as a limitation on authority to grant
                                                final rule in its entirety with the newly               Selected Reserve. This delayed
                                                                                                        termination exception applies regardless              exceptions to requirements of the
                                                revised section on TRICARE Reserve                                                                            section and to clarify that the Director,
                                                Select premiums in order to implement                   of type of TRS coverage actually in
                                                                                                                                                              Healthcare Operations in the Defense
                                                section 704 of NDAA–09. That had the                    effect at the time. This exception expires
                                                                                                                                                              Health Agency has authority to grant
                                                effect of removing all of the former                    December 31, 2018.
                                                                                                           We proposed to clarify the rule that               such exceptions and establish
                                                provisions involving the relationship                                                                         administrative rules and procedures for
                                                between premium rates for TRS and                       procedures may be established for TRS
                                                                                                        coverage to be suspended for up to one                TRS.
                                                premium rates for the Blue Cross and                                                                             3. Analysis of Major Public
                                                Blue Shield Standard Service Benefit                    year followed by final termination for
                                                                                                                                                              Comments. No public comments were
                                                Plan under the Federal Employees                        members or qualified survivors if they
                                                                                                                                                              received relating to this section of the
                                                Health Benefits program will appear in                  fail to make premium payments in
                                                                                                                                                              rule.
                                                the amended § 199.24(c). The final rule                 accordance with established procedures                   4. Provisions of the Final Rule. The
                                                is consistent with the proposed rule.                   or otherwise if they request suspension/              final rule is consistent with the
                                                                                                        termination of coverage (§ 199.24(d)(3)).             proposed rule.
                                                D. Procedures (§ 199.24(d))                             Suspension/termination of coverage for
                                                                                                        the TRS member/survivor will result in                G. Terminology (§ 199.25(g))
                                                1. Provisions of Interim Final Rule
                                                                                                        suspension/termination of coverage for                   1. Provisions of Interim Final Rule. In
                                                   The interim final rule addressed                     the member’s/survivor’s family                        the interim final rule, paragraph (g)
                                                procedures for TRS coverage.                            members in TRS, except as described in                addressed Administration (§ 199.25(g)).
                                                   2. Provisions of the Proposed Rule.                  § 199.24 (d)(1)(iv). We also proposed to                 2. Provisions of the Proposed Rule.
                                                We proposed to clarify that the Director,               clarify that procedures may be                        We proposed to redesignate paragraph
                                                Healthcare Operations in the Defense                    established for the suspension to be                  (g) as paragraph (f) and to add a new
                                                Health Agency may establish                             lifted upon request before final                      paragraph (g) regarding terminology.
                                                procedures for TRS (§ 199.24(d)).                       termination is applied.                               This would also remove the terminology
                                                   We proposed to clarify that either                      3. Analysis of Major Public                        under § 199.25(a)(4).
                                                reserve members or survivors qualified                  Comments. No public comments were                        3. Analysis of Major Public
                                                under § 199.24(b) may follow applicable                 received relating to this section of the              Comments. No public comments were
                                                procedures throughout this section                      rule.                                                 received relating to this section of the
                                                regarding TRS coverage. We proposed to                     4. Provisions of the Final Rule. The               rule.
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                                                clarify the rule about immediate family                 final rule is consistent with the interim                4. Provisions of the Final Rule. The
                                                members who may be included in                          final rule and the proposed rule.                     final rule is consistent with the
                                                family coverage under TRS                                                                                     proposed rule.
                                                (§ 199.24(d)(1)), which is further                      E. Preemption of State Laws
                                                supported by the proposed definition                    (§ 199.24(e))                                         V. Costs
                                                for immediate family member included                       1. Provisions of Interim Final Rule. In              Fiscal year 2014 through 2019 costs
                                                in § 199.24(g).                                         the interim final rule, paragraph (e)                 are anticipated to be $7,735,728.00:


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                                                55254               Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations

                                                                                                Government        PART 199—[AMENDED]                                    earlier than 180 days after the date on
                                                            Fiscal year                            cost                                                                 which the member is separated from the
                                                                                                                  ■ 1. The authority citation for part 199              Selected Reserve. This exception
                                                2014   ......................................     $1,296,884      continues to read as follows:                         expires December 31, 2018.
                                                2015   ......................................      1,373,929
                                                2016   ......................................      1,455,633        Authority: 5 U.S.C. 301; 10 U.S.C. chapter          *     *     *     *    *
                                                2017   ......................................      1,542,277      55.                                                   ■ 4. Amend § 199.24 as follows.
                                                2018   ......................................      1,634,096      ■ 2. Amend § 199.3 by revising                        ■ a. Remove paragraph (a)(4).
                                                2019   ......................................        432,909      paragraph (b)(5)(iii)(B) to read as                   ■ b. Redesignate paragraph (a)(5) as
                                                                                                                  follows:                                              paragraph (a)(4).
                                                   Total FY14–FY19 ..............                   7,735,728                                                           ■ c. Revise newly redesignated
                                                                                                                  § 199.3    Eligibility.                               paragraphs (a)(4)(i)(B), (a)(4)(iii), and
                                                VI. Regulatory Procedures                                         *      *    *    *      *                             (a)(4)(iv).
                                                                                                                    (b) * * *                                           ■ d. Redesignate paragraphs (b) and (c)
                                                  Executive Orders 12866 and 13563                                  (5) * * *                                           as paragraphs (c) and (b), respectively.
                                                require certain regulatory assessments                              (iii) * * *                                         ■ e. Revise newly redesignated
                                                for any significant regulatory action that                          (B) 180 days before the date on which               paragraphs (b) and (c).
                                                would result in an annual effect on the                           the period of active duty is to begin.                ■ f. Revise paragraph (d).
                                                economy of $100 million or more, or                                                                                     ■ g. Redesignate paragraphs (f) and (g)
                                                                                                                  *      *    *    *      *
                                                have other substantial impacts. The                                                                                     as paragraphs (e) and (f), respectively.
                                                Congressional Review Act establishes                              ■ 3. Amend § 199.13 by revising                       ■ h. Revise newly redesignated
                                                certain procedures for major rules,                               paragraph (c)(3)(ii)(E)(2) introductory               paragraph (f).
                                                defined as those with similar major                               text and adding paragraph (c)(3)(ii)(E)(5)            ■ i. Add new paragraph (g).
                                                impacts. The Regulatory Flexibility Act                           to read as follows:                                      The revisions and additions read as
                                                (RFA) requires that each Federal agency                           § 199.13    TRICARE Dental Program.
                                                                                                                                                                        follows:
                                                prepare, and make available for public
                                                                                                                  *      *    *     *     *                             § 199.24   TRICARE Reserve Select.
                                                comment, a regulatory flexibility                                   (c) * * *
                                                analysis when the agency issues a                                                                                          (a) * * *
                                                                                                                    (3) * * *                                              (4) * * *
                                                regulation that would have significant                              (ii) * * *                                             (i) * * *
                                                impact on a substantial number of small                             (E) * * *                                              (B) Certain special programs
                                                entities. This final rule is not subject to                         (2) Survivor eligibility. Eligible                  established in 32 CFR part 199 are not
                                                any of these requirements because it                              dependents of active duty members who                 available to members covered under
                                                will not have any of these substantial                            die while on active duty for a period of              TRICARE Reserve Select. These include
                                                impacts. However, this rule has been                              more than 30 days and eligible                        the Extended Care Health Option
                                                designated a ‘‘significant regulatory                             dependents of members of the Ready                    (§ 199.5), the Special Supplemental
                                                action,’’ although not economically                               Reserve (i.e., Selected Reserve or                    Food Program (see § 199.23), and the
                                                significant, under section 3(f) of                                Individual Ready Reserve, as specified                Supplemental Health Care Program
                                                Executive Order 12866. Accordingly,                               in 10 U.S.C. 10143 and 10144(b)                       (§ 199.16), except when referred by a
                                                the rule has been reviewed by the Office                          respectively) who die, shall be eligible              Military Treatment Facility (MTF)
                                                of Management and Budget (OMB).                                   for survivor enrollment in the TDP.                   provider for incidental consults and the
                                                  This rule will not impose additional                            During the period of survivor                         MTF provider maintains clinical control
                                                information collection requirements on                            enrollment, the government will pay                   over the episode of care. The TRICARE
                                                the public under the Paperwork                                    both the government and the eligible                  Dental Program (§ 199.13) is
                                                Reduction Act of 1995 (44 U.S.C. 3501–                            dependent’s portion of the premium                    independent of this program and is
                                                3511).                                                            share. This survivor enrollment shall be              otherwise available to all members of
                                                  We have examined the impact(s) of                               up to (3) three years from the date of the            the Selected Reserve and their eligible
                                                the final rule under Executive Order                              member’s death, except that, in the case              family members whether or not they
                                                13132 and it does not have policies that                          of a dependent of the deceased who is                 purchase TRICARE Reserve Select
                                                have federalism implications that will                            described in 10 U.S.C. 1072(2)(D) or (I),             coverage. The Continued Health Care
                                                have substantial direct effects on the                            the period of survivor enrollment shall               Benefits Program (§ 199.20) is also
                                                States, on the relationship between the                           be the longer of the following periods                independent of this program and is
                                                national government and the States, or                            beginning on the date of the member’s                 otherwise available to all members who
                                                on the distribution of power and                                  death:                                                qualify.
                                                responsibilities among the various                                *      *    *     *     *                             *       *    *     *    *
                                                levels of government. The preemption                                (5) TRICARE Dental Program coverage                    (iii) Procedures. Under TRICARE
                                                provisions in the rule conform to law                             shall terminate for members who no                    Reserve Select, Reserve Component
                                                and long-established TRICARE policy.                              longer qualify for the TRICARE Dental                 members who fulfilled all of the
                                                Therefore, consultation with State and                            Program as specified in paragraph (c)(2)              statutory qualifications may purchase
                                                local officials is not required.                                  of this section, with one exception. If a             either the member-only type of coverage
                                                                                                                  member is involuntarily separated from                or the member-and-family type of
                                                List of Subjects in 32 CFR Part 199                               the Selected Reserve under other than                 coverage by submitting a completed
                                                  Claims, Handicapped, Health                                     adverse conditions, as characterized by               request in the appropriate format along
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                                                insurance, Military personnel.                                    the Secretary concerned, and TRICARE                  with an initial payment of the
                                                                                                                  Dental Program coverage is in effect for              applicable premium. Rules and
                                                  Accordingly, the interim final rule                             the member and/or the family on the                   procedures for purchasing coverage and
                                                published at 72 FR 46380 on August 20,                            last day of his or her membership in the              paying applicable premiums are
                                                2007, amending 32 CFR part 199 is                                 Selected Reserve; then the TRICARE                    prescribed in this section.
                                                adopted as a final rule with the                                  Dental Program coverage that was                         (iv) Benefits. When their coverage
                                                following changes:                                                actually in effect may terminate no                   becomes effective, TRICARE Reserve


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                                                                 Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations                                     55255

                                                Select beneficiaries receive the                           (c) TRICARE Reserve Select                         member to purchase one of two types of
                                                TRICARE Standard (and Extra) benefit                    premiums. Members are charged                         coverage: Member-only coverage or
                                                including access to military treatment                  premiums for coverage under TRICARE                   member and family coverage. Immediate
                                                facility services and pharmacies, as                    Reserve Select that represent 28 percent              family members of a qualified member
                                                described in §§ 199.17 and 199.21.                      of the total annual premium amount                    as specified in paragraph (g)(2) of this
                                                TRICARE Reserve Select coverage                         that the Director, Defense Health                     section may be included in such family
                                                features the deductible and cost share                  Agency determines on an appropriate                   coverage. To purchase either type of
                                                provisions of the TRICARE Standard                      actuarial basis as being appropriate for              TRICARE Reserve Select coverage for
                                                (and Extra) plan applicable to active                   coverage under the TRICARE Standard                   effective dates of coverage described
                                                duty family members for both the                        (and Extra) benefit for the TRICARE                   below, members and survivors qualified
                                                member and the member’s covered                         Reserve Select eligible population.                   under either paragraph (b)(1) or (2) of
                                                family members (paragraph (a)(4)(iv) of                 Premiums are to be paid monthly,                      this section must submit a request in the
                                                this section). Both the member and the                  except as otherwise provided through                  appropriate format, along with an initial
                                                member’s covered family members are                     administrative implementation,                        payment of the applicable premium
                                                provided access priority for care in                    pursuant to procedures established by                 required by paragraph (c) of this section
                                                military treatment facilities on the same               the Director, Healthcare Operations in                in accordance with established
                                                basis as active duty service members’                   the Defense Health Agency. The                        procedures.
                                                dependents who are not enrolled in                      monthly rate for each month of a                         (i) Continuation coverage. Procedures
                                                TRICARE Prime as described in                           calendar year is one-twelfth of the                   may be established for a qualified
                                                § 199.17(d)(1)(i)(D).                                   annual rate for that calendar year.                   member or qualified survivor to
                                                   (b) Qualifications for TRICARE                          (1) Annual establishment of rates.                 purchase TRICARE Reserve Select
                                                Reserve Select coverage—(1) Ready                       TRICARE Reserve Select monthly                        coverage with an effective date
                                                Reserve member. A Ready Reserve                         premium rates shall be established and                immediately following the date of
                                                member qualifies to purchase TRICARE                    updated annually on a calendar year                   termination of coverage under another
                                                Reserve Select coverage if the Service                  basis for each of the two types of                    TRICARE program.
                                                member meets both the following                         coverage, member-only and member-                        (ii) Qualifying life event. Procedures
                                                criteria:                                               and-family as described in paragraph                  may be established for a qualified
                                                   (i) Is a member of the Selected                      (d)(1) of this section. Starting with                 member or qualified survivor to
                                                                                                        calendar year 2009, the appropriate                   purchase TRICARE Reserve Select
                                                Reserve of the Ready Reserve of the
                                                                                                        actuarial basis for purposes of this
                                                Armed Forces, or a member of the                                                                              coverage on the occasion of a qualifying
                                                                                                        paragraph (c) shall be determined for
                                                Individual Ready Reserve of the Armed                                                                         life event that changes the immediate
                                                                                                        each calendar year by utilizing the
                                                Forces who has volunteered to be                                                                              family composition (e.g., birth,
                                                                                                        actual reported cost of providing
                                                ordered to active duty pursuant to the                                                                        adoption, divorce, etc.) that is eligible
                                                                                                        benefits under this section to members
                                                provisions of 10 U.S.C. 12304 in                                                                              for coverage under TRICARE Reserve
                                                                                                        and their dependents during the
                                                accordance with section 10 U.S.C.                                                                             Select. The effective date for TRICARE
                                                                                                        calendar years preceding such calendar
                                                10144(b); and                                                                                                 Reserve Select coverage will coincide
                                                                                                        year. Reported actual TRS cost data
                                                   (ii) Is not enrolled in, or eligible to                                                                    with the date of the qualifying life
                                                                                                        from calendar years 2006 and 2007 was
                                                enroll in, a health benefits plan under                                                                       event. It is the responsibility of the
                                                                                                        used to determine premium rates for
                                                5 U.S.C. chapter 89. That statute has                   calendar year 2009. This established                  member to provide personnel officials
                                                been implemented under 5 CFR part 890                   pattern will be followed to determine                 with the necessary evidence required to
                                                as the Federal Employees Health                         premium rates for all calendar years                  substantiate the change in immediate
                                                Benefits (FEHB) program. For purposes                   subsequent to 2009.                                   family composition. Personnel officials
                                                of the FEHB program, the terms                             (2) Premium adjustments. In addition               will update DEERS in the usual manner.
                                                ‘‘enrolled,’’ ‘‘enroll’’ and ‘‘enrollee’’ are           to the determinations described in                    Appropriate action will be taken upon
                                                defined in 5 CFR 890.101. Further, the                  paragraph (c)(1) of this section,                     receipt of the completed request in the
                                                member (or certain former member                        premium adjustments may be made                       appropriate format along with an initial
                                                involuntarily separated) no longer                      prospectively for any calendar year to                payment of the applicable premium in
                                                qualifies for TRICARE Reserve Select                    reflect any significant program changes               accordance with established procedures.
                                                when the member (or former member)                      or any actual experience in the costs of                 (iii) Open enrollment. Procedures may
                                                has been eligible for coverage to be                    administering TRICARE Reserve Select.                 be established for a qualified member to
                                                effective in a health benefits plan under                  (3) Survivor premiums. A surviving                 purchase TRICARE Reserve Select
                                                the FEHB program for more than 60                       family member of a Reserve Component                  coverage at any time. The effective date
                                                days.                                                   service member who qualified for                      of coverage will coincide with the first
                                                   (2) TRICARE Reserve Select survivor.                 TRICARE Reserve Select coverage as                    day of a month.
                                                If a qualified Service member dies while                described in paragraph (b)(2) of this                    (iv) Survivor coverage under TRICARE
                                                in a period of TRICARE Reserve Select                   section will pay premium rates as                     Reserve Select. Procedures may be
                                                coverage, the immediate family                          follows. The premium amount shall be                  established for a surviving family
                                                member(s) of such member is qualified                   at the member-only rate if there is only              member of a Reserve Component service
                                                to purchase new or continue existing                    one surviving family member to be                     member who qualified for TRICARE
                                                TRICARE Reserve Select coverage for up                  covered by TRICARE Reserve Select and                 Reserve Select coverage as described in
                                                to six months beyond the date of the                    at the member and family rate if there                paragraph (b)(2) of this section to
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                                                member’s death as long as they meet the                 are two or more survivors to be covered.              purchase new TRICARE Reserve Select
                                                definition of immediate family members                     (d) Procedures. The Director,                      coverage or continue existing TRICARE
                                                as specified in paragraph (g)(2) of this                Healthcare Operations in the Defense                  Reserve Select coverage for up to six
                                                section. This applies regardless of type                Health Agency, may establish                          months beyond the date of the member’s
                                                of coverage in effect on the day of the                 procedures for the following.                         death. The effective date of coverage
                                                TRICARE Reserve Select member’s                            (1) Purchasing coverage. Procedures                will be the day following the date of the
                                                death.                                                  may be established for a qualified                    member’s death.


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                                                55256            Federal Register / Vol. 80, No. 178 / Tuesday, September 15, 2015 / Rules and Regulations

                                                   (2) Changing type of coverage.                         (5) Periodic revision. Periodically,                Northern Santa Fe (BNSF) Railway
                                                Procedures may be established for                       certain features, rules or procedures of              Bridge across the Snake River, mile 1.5,
                                                TRICARE Reserve Select members to                       TRICARE Reserve Select may be                         at Burbank, WA. The deviation is
                                                request to change type of coverage                      revised. If such revisions will have a                necessary to accommodate maintenance
                                                during open enrollment as described in                  significant effect on members’ or                     to replace movable rail joints. This
                                                paragraph (d)(1)(iii) of this section or on             survivors’ costs or access to care,                   deviation allows the bridge to remain in
                                                the occasion of a qualifying life event                 members or survivors may be given the                 the closed-to-navigation position during
                                                that changes immediate family                           opportunity to change their type of                   maintenance activities.
                                                composition as described in paragraph                   coverage or terminate coverage                        DATES: This deviation is effective from
                                                (d)(1)(ii) of this section by submitting a              coincident with the revisions.                        7 a.m. on September 28, 2015 until 7
                                                completed request in the appropriate                    *     *      *    *     *                             p.m. on October 1, 2015.
                                                format.                                                   (f) Administration. The Director,                   ADDRESSES: The docket for this
                                                   (3) Suspension and termination.                      Healthcare Operations in the Defense                  deviation, [USCG–2015–0873] is
                                                Suspension/termination of coverage for                  Health Agency may establish other rules               available at http://www.regulations.gov.
                                                the TRS member/survivor will result in                  and procedures for the effective                      Type the docket number in the
                                                suspension/termination of coverage for                  administration of TRICARE Reserve                     ‘‘SEARCH’’ box and click ‘‘SEARCH.’’
                                                the member’s/survivor’s family                          Select, and may authorize exceptions to               Click on Open Docket Folder on the line
                                                members in TRICARE Reserve Select,                      requirements of this section, if                      associated with this deviation. You may
                                                except as described in paragraph                        permitted by law.                                     also visit the Docket Management
                                                (d)(1)(iv) of this section. Procedures may                (g) Terminology. The following terms                Facility in Room W12–140 on the
                                                be established for coverage to be                       are applicable to the TRICARE Reserve                 ground floor of the Department of
                                                suspended or terminated as follows.                     Select program.                                       Transportation West Building, 1200
                                                   (i) Coverage shall terminate when                      (1) Coverage. This term means the                   New Jersey Avenue SE., Washington,
                                                members or survivors no longer qualify                  medical benefits covered under the                    DC 20590, between 9 a.m. and 5 p.m.,
                                                for TRICARE Reserve Select as specified                 TRICARE Standard or Extra programs as                 Monday through Friday, except Federal
                                                in paragraph (b) of this section, with one              further outlined in other sections of 32              holidays.
                                                exception. If a member is involuntarily                 CFR part 199 whether delivered in                     FOR FURTHER INFORMATION CONTACT: If
                                                separated from the Selected Reserve                     military treatment facilities or                      you have questions on this temporary
                                                under other than adverse conditions, as                 purchased from civilian sources.                      deviation, call or email Mr. Steven
                                                characterized by the Secretary                            (2) Immediate family member. This                   Fischer, Bridge Administrator,
                                                concerned, and is covered by TRICARE                    term means spouse (except former                      Thirteenth Coast Guard District;
                                                Reserve Select on the last day of his or                spouses) as defined in § 199.3(b)(2)(i), or           telephone 206–220–7282, email d13-pf-
                                                her membership in the Selected                          child as defined in § 199.3(b)(2)(ii).                d13bridges@uscg.mil. If you have
                                                Reserve, then TRICARE Reserve Select                      (3) Qualified member. This term                     questions on viewing the docket, call
                                                coverage may terminate up to 180 days                   means a member who has satisfied all                  Cheryl Collins, Program Manager,
                                                after the date on which the member was                  the criteria that must be met before the              Docket Operations, telephone 202–366–
                                                separated from the Selected Reserve.                    member is authorized for TRS coverage.                9826.
                                                This applies regardless of type of                        (4) Qualified survivor. This term                   SUPPLEMENTARY INFORMATION: BNSF has
                                                coverage. This exception expires                        means an immediate family member                      requested that the BNSF Snake River
                                                December 31, 2018.                                      who has satisfied all the criteria that               Bridge across the Snake River, mile 1.5,
                                                   (ii) Coverage may terminate for                      must be met before the survivor is                    remain in the closed-to-navigation
                                                members, former members, and                            authorized for TRS coverage.                          position to vessel traffic to perform
                                                survivors who gain coverage under                         Dated: September 4, 2015.                           railroad bridge maintenance. During this
                                                another TRICARE program.                                Aaron Siegel,                                         maintenance period, movable rail joints
                                                   (iii) Coverage may be suspended and                  Alternate OSD Federal Register Liaison                will be replaced at both ends of the lift
                                                finally terminated for members/                         Officer, Department of Defense.                       span. The BNSF Snake River Bridge,
                                                survivors who fail to make premium                      [FR Doc. 2015–22815 Filed 9–14–15; 8:45 am]           mile 1.5, provides 14.1 feet of vertical
                                                payments in accordance with                                                                                   clearance above Columbia River Datum
                                                                                                        BILLING CODE 5001–06–P
                                                established procedures.                                                                                       0.0 while in the closed position. The
                                                   (iv) Coverage may be suspended and                                                                         normal operating schedule for the BNSF
                                                finally terminated for members/                                                                               Snake River Bridge 3.08 operates in
                                                survivors upon request at any time by                   DEPARTMENT OF HOMELAND
                                                                                                        SECURITY                                              accordance with 33 CFR 117.1058, and
                                                submitting a completed request in the                                                                         is automated and is normally
                                                appropriate format in accordance with                   Coast Guard                                           maintained in the fully open-to-
                                                established procedures.                                                                                       navigation position.
                                                   (v) Under paragraph (d)(3)(iii) or (iv)              33 CFR Part 117                                          The deviation allows the lift span of
                                                of this section, TRICARE Reserve Select                                                                       the BNSF Snake River Bridge across the
                                                coverage may first be suspended for a                   [Docket No. USCG–2015–0873]                           Snake River, mile 1.5, to remain in the
                                                period of up to one year followed by                                                                          closed-to-navigation position, and need
                                                final termination. Procedures may be                    Drawbridge Operation Regulation;                      not open for maritime traffic from 7 a.m.
                                                established for the suspension to be                    Snake River, Burbank, WA                              to 3 p.m. on September 28, 2015; from
mstockstill on DSK4VPTVN1PROD with RULES




                                                lifted upon request before final                        AGENCY: Coast Guard, DHS.                             7 a.m. to 7 p.m. on September 29, 2015;
                                                termination is applied.                                 ACTION:Notice of deviation from                       from 7 a.m. to 3 p.m. on September 30,
                                                   (4) Processing. Upon receipt of a                    drawbridge regulation.                                2015; and from 7 a.m. to 7 p.m. on
                                                completed request in the appropriate                                                                          October 1, 2015. During the active
                                                format, enrollment actions will be                      SUMMARY:  The Coast Guard has issued a                maintenance, BNSF will lower the lift
                                                processed into DEERS in accordance                      temporary deviation from the operating                span in closed-to-navigation position.
                                                with established procedures.                            schedule that governs the Burlington                  Waterway usage on this part of the


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Document Created: 2015-12-15 10:09:58
Document Modified: 2015-12-15 10:09:58
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionRules and Regulations
ActionFinal rule.
DatesThis rule is effective October 15, 2015.
ContactBrian Smith, Defense Health Agency, TRICARE Health Plan Division, telephone (703) 681-0039.
FR Citation80 FR 55250 
RIN Number0720-AB15
CFR AssociatedClaims; Handicapped; Health Insurance and Military Personnel

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