SUPPORTING STATEMENT FOR PAPERWORK REDUCTION ACT SUBMISSION
JUSTIFICATION
Needs and Use
The Ike Skelton National Defense Authorization Act for Fiscal Year 2011 (FY11), Section 702, aligns TRICARE Program eligibility by providing a means to extend the age of eligibility of TRICARE dependents from age 21 or 23 up to age 26 to allow the purchase of extended dependent medical coverage across existing TRICARE program options (Standard, Extra, and Prime). This is consistent with the intent of the Patient Protection and Affordable Care Act, the implementing Health and Human Services regulations, and the limitations of Chapter 55 of Title 10. Section 702 allows qualified adult children not eligible for medical coverage at age 21 (23 if enrolled in a full-time course of study at an institution of higher learning approved by the Secretary of Defense) and are under age 26 to qualify to purchase medical coverage unless the dependent is enrolled in or eligible to purchase employer sponsored insurance per section 5000A(f)(2) of the Internal Revenue Code of 1986 or is married. The dependents shall be able to purchase either the TRICARE Prime or Standard/Extra benefits depending meeting specific program requirements and the availability of a desired plan in their geographic location.
The TRICARE Young Adult Application will be used by former dependents to apply for, change, or terminate their TRICARE Young Adult coverage.
Purpose and users of the information
Information gathered through this collection will be used by the regional managed care support contractors to process the applications to start, change, or terminate TRICARE Young Adult coverage.
Information Collection Techniques
Adult age dependents will obtain an electronic version of the application form via the TRICARE.mil website. When they identify their geographical location via their residential ZIP code, they will be presented with an application form that contains the contact information for the correct regional contractor responsible for processing the application. They can either complete the form online, or download an electronic portable data format (.pdf) file to a computer to be completed, then print, sign, and then submit the hardcopy application for processing.
The form may also be accessed via the Beneficiary Web Enrollment (BWE) website at https://www.dmdc.osd.mil/appj/bwe/indexAction.do . They will complete the form via the Internet, and then print the form and submit it in hardcopy after signing the application. .
Regional contractors will also have printed versions of the form available for former dependents to complete.
Duplication and Similar Information
This collection is not duplicative. Collection of this information is necessary to complete the purchase of TRICARE Young Adult coverage.
Small Business
This collection of information does not involve small businesses or other small entities.
Less Frequent Collections
Collection of information is necessary upon the initial application to purchase coverage, when a changes in coverage is requested, and upon request to terminate coverage.
Special Circumstances
There are no special circumstances that require the collection to be conducted in a manner inconsistent with the guidelines in 5 CFR 1320.5 (d) (2)
Federal Register Notice/Consultations
Public comments will be solicited in the preamble of the interim final rule. This Supporting Statement will be modified to address any comments received on the information collection portion of the interim final rule.
Payment/Gift to Respondents
None
Confidentiality
The information will be maintained and protected in accordance with the Privacy Act and follows data systems security requirements.
Sensitive Questions
The TRICARE Young Adult application contains a section at the top of page 1 regarding the Privacy Act Statement. Entities with whom the DoD has contracted to process TRICARE Young Adult application functions is contractually required to adhere to the legal requirements associated with the Privacy Act as well as instructions and guidelines furnished by the TRICARE Management Activity regarding the confidentially of information and data collected under the contract and the penalties for unauthorized release of that information. The contractors are seasoned contractors that are well aware of the Privacy Act and include Privacy Act training when they orient all new employees. The contractors likewise have significant private sector experience handling confidential patient information for their commercial line of business.
Burden Estimated (hours)
The total annual burden hours for respondents are 8,000 hours. It is based on a projection of 16,000 adult age dependents submitting applications on average twice a year to start, change, or terminate their TRICARE Young Adult coverage. The burden is based on an estimate of 15 minutes (.25 hours) to complete the application. .
Cost to Respondents
None
Cost of Federal Government
The Department of Defense contracts with the current regional support contractors to process the completed applications. If requested, a paper version of the form will be provided by the regional contractors to an adult age dependent. Those costs are already included in the overall administrative costs for each current contract.
Change in Burden
This is an initial request.
Publication/Tabulation
Information gathered through this collection will be used to permit adult age dependents to purchase, change, or terminate their TRICARE Young Adult coverage. It will be used by government contractors to administer the TRICARE Young Adult benefit through collection of healthcare premiums and payment of healthcare claims.
Expiration Date
DoD does not request an exception to the display of the OMB expiration date.
There are no exceptions to the certification statement in Item 19 of OMB Form 83-1.
COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS
This collection of information does not employ statistical methods.
| File Type | application/msword |
| File Title | SUPPORTING STATEMENT FOR PAPERWORK REDUCTION ACT SUBMISSION |
| Author | Terri Tanielian |
| Last Modified By | pltoppings |
| File Modified | 2011-03-04 |
| File Created | 2011-01-19 |