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DOD/DODOASHA RIN: 0720-AB56 Publication ID: Spring 2015 
Title: Uniform Health Maintenance Organization (HMO) Benefit--Prime Enrollment Fee Exemption 
Abstract:

This rule created an exception to the usual rule that TRICARE Prime enrollment fees are uniform for all retirees and their dependents. Survivors of Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents are part of the retiree group under TRICARE rules. In acknowledgment and appreciation of the sacrifices of these two beneficiary categories, the Secretary of Defense has elected to exercise his authority under Title 10 of the United States Code, section 1097(e) to exempt Active Duty Deceased Sponsors and Medically Retired Uniformed Services Members and their Dependents enrolled in TRICARE Prime from paying future increases to the TRICARE Prime annual enrollment fees. Section 1097(e) states, "The Secretary of Defense may prescribe by regulation a premium, deductible, co-payment, or other charge for health care provided under this section.” The Prime beneficiaries in these categories have made significant sacrifices for our country and are entitled to special recognition and benefits for their sacrifices. Therefore, the beneficiaries in these two TRICARE beneficiary categories who enrolled in TRICARE Prime prior to 10/1/2013 will have their annual enrollment fee frozen at their current annual rate (FY2011 rate $230 per single or $460 per family, FY2012 rate $260 or $520, or the FY2013 rate $269.38 or $538.56). The beneficiaries added to these categories on or after the effective date of this regulation will have their fee frozen at the rate in effect at the time they are classified in either category and enroll in TRICARE Prime or, if not enrolling, at the rate in effect at the time of enrollment. The fee remains frozen as long as at least one family member remains enrolled in TRICARE Prime and there is not a break in enrollment. The fee charged for the dependent(s) of a Medically Retired Uniformed Services Member would not change if the dependent(s) was later re-classified a Survivor.

 
Agency: Department of Defense(DOD)  Priority: Substantive, Nonsignificant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Completed Actions 
Major: No  Unfunded Mandates: No 
CFR Citation: 32 CFR 199   
Legal Authority: 10 U.S.C. ch 55    5 U.S.C. 301   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  06/07/2013  78 FR 34292   
NPRM Comment Period End  08/06/2013 
NPRM  08/08/2013  78 FR 48366   
Correction  08/19/2013  78 FR 50359   
Final Action  09/30/2014  79 FR 58680   
Final Action Effective  10/30/2014 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Small Entities Affected: No  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Ralph (Doug) McBroom
TRICARE and Policy Benefits Office, Defense Health Agency
Department of Defense
Office of Assistant Secretary for Health Affairs
Buckley Air Force Base, 18500 E. Sixth Avenue,
Aurora, CO 80011
Phone:303 676-3533
Email: ralph.d.mcbroom.civ@mail.mil