SUPPORTING STATEMENT - PART A
TRICARE Young Adult Application – 0720-0049
1. Need for the Information Collection
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 (Select 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 TRICARE Prime or Select benefits depending on specific program requirements and the availability of a desired plan in their geographic location.
2. Use of the Information
Each respondent has the option of using the DD-2947, “TRICARE Young Adult Application,” there are three versions of the form depending on what region the respondent resides (DD2947-1 (East), DD2947-2 (West) and (DD2947-3 (Overseas)), Beneficiary Web Enrollment (BWE) or a telephone call to their Regional Contractor to enroll, dis-enroll or change their enrollment. The large majority of all transactions are initiated by the beneficiary calling their Regional Contractor. They prefer this method since the action requested is immediately updated, with confirmation of completion provided by the Customer Service Representative taking the call. It also gives the beneficiary an opportunity to ask any questions they may have regarding their TRICARE benefits.
The other option available for beneficiaries to request enrollment, disenrollment or a change is to use the BWE portal. BWE is accessible to all TRICARE beneficiaries via milconnect at https://milconnect.dmdc.osd.mil/milconnect/. It is also available through links on www.tricare.mil and the Regional Contractors’ websites. The portal is an application that validates the eligibility of the beneficiary using each beneficiary’s PII stored in the Defense Enrollment Eligibility Reporting System (DEERS). PII is not collected and stored by the BWE application, only validated with DEERS and then used to notify the appropriate Regional Contractor of the action requested. The BWE pages mirror the DD-2947 to ensure the information needed is available to the Regional Contractor. The information is validated by DEERS which stores all PII. The Regional Contractor has six days to approve and process the requested action or to request additional information. After the enrollment action is complete, a notification is sent to the beneficiary.
If respondents choose to use the DD-2947, they must complete the form and mail the form to their appropriate Regional Contractor. No other form is required to enroll, dis-enroll or change an enrollment. Respondents can download a copy of the form from the TRICARE.mil website or their Regional Contractor’s website or obtain a copy from their local military hospital or clinic. The mailing address and toll-free customer service number for the appropriate Regional Contractor are included on the DD-2947. If using either website option, the respondent can type in the information on the form prior to printing it or handwrite the information after printing the blank form.
The successful collection of this information allows adult age dependents to enroll in TRICARE Young Adult health coverage and make the appropriate or necessary changes for continued coverage.
3. Use of Information Technology
About 21% of responses are collected electronically via the BWE. None of the forms can be completed and electronically submitted to the Regional Contractor via email or by uploading them. The forms are manually completed and must be signed and mailed to the Regional Contractor as described in section 2 above. Forms are required to be signed and mailed to the Regional Contractors for the foreseeable future to ensure eligibility verification is processed correctly.
4. Non-duplication
The information obtained through this collection is unique and is not already available for use or adaptation from another cleared source.
5. Burden on Small Businesses
This information collection does not impose a significant economic impact on a substantial number of small businesses or entities.
6. Less Frequent Collection
This information is collected as required; collection of the information is necessary upon the initial application to purchase coverage, when a change in coverage is requested, upon request to terminate coverage, or to request change in PCM. Reducing the collection of information to occur less frequently would result in beneficiaries experiencing loss of healthcare coverage or maintaining coverage when they no longer desire to continue it.
7. Paperwork Reduction Act Guidelines
This collection of information does not require collection to be conducted in a manner inconsistent with the guidelines delineated in 5 CFR 1320.5(d)(2).
8. Consultation and Public Comments
Part A: PUBLIC NOTICE
A 60-Day Federal Register Notice (FRN) for the collection published on Monday, October 25, 2021. The 60-Day FRN citation is 86 FRN 58898.
No comments were received during the 60-Day Comment Period.
A 30-Day Federal Register Notice for the collection published on Wednesday, December 22, 2021. The 30-Day FRN citation is 86 FRN 72584-72585.
Part B: CONSULTATION
Within a working group internal to the Department of Defense, we have consulted with U.S. military service representatives and subject matter experts of the Defense Enrollment Eligibility Reporting System (DEERS) in order to ensure the design and processing of the DD-2947 are the most efficient.
9. Gifts or Payment
No payments or gifts are being offered to respondents as an incentive to participate in the collection.
10. Confidentiality
A Privacy Act Statement is required for this collection and provided on the form because we are requesting individuals to furnish personal information for to be stored in a system of records and retrieved by a personal identifier.
The applicable System of Record Notice (SORN) is DMDC 02, Defense Enrollment Eligibility Reporting System, located at: https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/627618/dmdc-02-dod/
The Privacy Impact Assessment (PIA) the Defense Enrollment Eligibility Reporting System (DEERS) can be accessed using the following URL: https://milconnect.dmdc.osd.mil/
Records Retention and Disposition Schedule:
Records will be maintained in accordance with the following approved schedule:
FILE NUMBER: 911-01
DISPOSITION: Temporary. Cut off at end of the calendar year in which received. Destroy 10 years after cutoff.
AUTHORITY: DAA-0330-2014-0014-0001
PRIVACY ACT: EDTMA 04
11. Sensitive Questions
The form requests the applicant provide a personal identifier number, which may be either than the individual’s social security number (SSN) or the DoD Benefit Number (DBN). The DBN has yet to be widely used and known by beneficiaries for healthcare transactions. Additionally, the main data source to find the DBN is the Uniformed Services identification card (ID card). Since the applicants are former dependent children, they either never had access to their DBN on an ID card in the first place or no longer have access to their DBN when they turned in their ID card after aging out of military benefits. Requesting the SSN or DBN of respondents is necessary to determine coverage eligibility, tracking purposes and to confirm the respondent has been enrolled in coverage via DEERS. For these reasons, DHA has justified the continued use of the SSN until such time the DBN is readily known by beneficiaries through repeated use and through means of knowing the DBN from documents other than the ID card. An SSN Justification Memorandum has been submitted as part of this information collection package.
12. Respondent Burden and its Labor Costs
Part A: ESTIMATION OF RESPONDENT BURDEN
1a) DD-2947
Number of Respondents: 2,709
Number of Responses Per Respondent: 1
Number of Total Annual Responses: 2,709
Response Time: 15 minutes
Respondent Burden Hours: 677.25 hours
2) Total Submission Burden
Total Number of Respondents: 2,709
Total Number of Annual Responses: 1
Total Respondent Burden Hours: 677.25 hours
Part B: LABOR COST OF RESPONDENT BURDEN
DD2947
Number of Total Annual Responses: 2,709
Response Time: 15 minutes
Respondent Hourly Wage: $ 7.25
Labor Burden per Response: $ 1.81
Total Labor Burden: $ 4,910.06
Overall Labor Burden
Total Number of Annual Responses: 2,709
Total Labor Burden: $ 4,910.06
The Respondent hourly wage was determined by using the [Department of Labor Wage Website] ([http://www.dol.gov/dol/topic/wages/index.htm])
13. Respondent Costs Other Than Burden Hour Costs
Less than 100 respondents submit the DD-2947 to their regional contractor for processing by mail. Based on current U.S. postal rates, we estimate respondents will spend $58.00 annually on postage.
14. Cost to the Federal Government
Part A: LABOR COST TO THE FEDERAL GOVERNMENT
DD-2947-1
Number of Total Annual Responses: 2,709
Processing Time per Response: 15 minutes
Hourly Wage of Worker(s) Processing Responses : $ 23.06
Cost to Process Each Response: $ 5.765
Total Cost to Process Responses : $ 15,617.39
Overall Labor Burden to the Federal Government
Total Number of Annual Responses: 2,709
Total Labor Burden: $ 15,617.39
Part B: OPERATIONAL AND MAINTENANCE COSTS
Cost Categories
Equipment: $0
Printing: $0
Postage: $0
Software Purchases: $0
Licensing Costs: $0
Other: $0
Total Operational and Maintenance Cost: $0.00
Part C: TOTAL COST TO THE FEDERAL GOVERNMENT
Total Labor Cost to the Federal Government: $15,617.39
Total Operational and Maintenance Costs: $0
Total Cost to the Federal Government: $15,617.39
15. Reasons for Change in Burden
There has been no change in burden since the last approval.
16. Publication of Results
The results of this information collection will not be published.
17. Non-Display of OMB Expiration Date
We are not seeking approval to omit the display of the expiration date of the OMB approval on the collection instrument.
18. Exceptions to “Certification for Paperwork Reduction Submissions”
We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.
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| File Created | 0000-00-00 |