The DoD has submitted to the Office of Management and Budget (OMB) for clearance the following proposal for collection of information under the provisions of the Paperwork Reduc...
Office of the Assistant Secretary of Defense for Health Affairs (OASD(HA)), Department of Defense (DoD).
ACTION:
30-Day information collection notice.
SUMMARY:
The DoD has submitted to the Office of Management and Budget (OMB) for clearance the following proposal for collection of information under the provisions of the Paperwork Reduction Act.
DATES:
Consideration will be given to all comments received by October 23, 2024.
ADDRESSES:
Written comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice to
www.reginfo.gov/public/do/PRAMain.
Find this particular information collection by selecting “Currently under 30-day Review—Open for Public Comments” or by using the search function.
Title; Associated Form; and OMB Number:
TRICARE Select Enrollment, Disenrollment, and Change Form; DD Form 3043; OMB Control Number 0720-0061.
Type of Request:
Revision.
Number of Respondents:
116,105.
Responses per Respondent:
1.
Annual Responses:
116,105.
Average Burden per Response:
15 minutes.
Annual Burden Hours:
29,026.
Needs and Uses:
The information collection requirement is necessary to obtain each non-active-duty TRICARE beneficiary's personal information
( printed page 77491)
needed to: (1) Complete his/her enrollment into the TRICARE Select health plan option, (2) dis-enroll a beneficiary, or (3) change a beneficiary's enrollment information (
e.g.,
address, add a dependent, report other health insurance). This information is required to ensure the beneficiary's TRICARE benefits and claims are administered based on their TRICARE plan of choice. Without this new enrollment form, each non-active-duty TRICARE beneficiary is automatically defaulted into direct care, limiting their health care options to beneficiaries would have no TRICARE coverage when using the TRICARE network of providers for services not available at their local military hospital or clinic.
Affected Public:
Individuals or households.
Frequency:
On occasion.
Respondent's Obligation:
Voluntary.
OMB Desk Officer:
Mr. Matt Eliseo.
You may also submit comments and recommendations, identified by Docket ID number and title, by the following method:
Instructions:
All submissions received must include the agency name, Docket ID number, and title for this
Federal Register
document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the internet at
http://www.regulations.gov
as they are received without change, including any personal identifiers or contact information.