[Federal Register Volume 76, Number 180 (Friday, September 16, 2011)]
[Rules and Regulations]
[Pages 57637-57641]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-23760]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF DEFENSE

Office of the Secretary

32 CFR Part 199

[DOD-2009-HA-0068]
RIN 0720-AB30


TRICARE; Continued Health Care Benefit Program Expansion

AGENCY: Office of the Secretary, Department of Defense.

ACTION: Final rule.

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

SUMMARY: This final rule executes the expansion of section 1078a of 
title 10, United States Code (U.S.C). With the recent expansions of 
Military Health System (MHS) coverage, particularly with the Reserve 
Component (RC) members, some MHS beneficiaries would not be eligible to 
purchase Continued Health Care Benefit Program (CHCBP) coverage under 
certain circumstances that terminate their MHS coverage. This provision 
allows the Secretary to establish CHCBP eligibility for any category of 
MHS beneficiaries who otherwise would lose MHS coverage with no 
continued care eligibility. Although the proposed rule listed each 
authorized category of MHS beneficiary eligible to receive care, on 
further examination this format for the rule appeared cumbersome and 
perhaps confusing. Thus this final rule contains some organizational 
changes to simplify the rule to enhance understanding and make clear 
that any category including future categories of beneficiaries are 
entitled to purchase this CHCBP coverage. This final rule also includes 
administrative changes providing clarification on eligibility 
notifications and the CHCBP premium rate publication process. It 
updates the previous final rule published in the Federal Register on 
September 30, 1994.

DATES: Effective Date: October 17, 2011.

FOR FURTHER INFORMATION CONTACT: Mr. Mark Ellis, TRICARE Policy and 
Operations, TRICARE Management Activity, 5111 Leesburg Pike, Suite 810, 
Falls Church, VA 22041, telephone (703) 681-0039.

SUPPLEMENTARY INFORMATION:

[[Page 57638]]

I. Introduction and Background

    CHCBP is the program that provides continued health care coverage 
for eligible beneficiaries who lose their MHS eligibility. It was 
initially established by Congress in section 4408 of the National 
Defense Authorization Act (NDAA) for Fiscal Year (FY) 1993, Public Law 
102-484, which amended title 10 U.S.C., by adding section 1078a. The 
Department of Defense (DoD) published the initial final rule regarding 
CHCBP in the Federal Register on September 30, 1994, (59 FR 49817). It 
is modeled after private sector insurance programs giving some 
employees the ability to continue health insurance coverage after 
leaving employment as authorized by the Consolidated Omnibus Budget 
Reconciliation Act (COBRA) of 1985. ``COBRA Coverage'' requires the 
individual to pay up to 100 percent of the program cost plus an amount 
to cover administrative expenses.
    Section 713 of the NDAA for FY 2004 expanded the category of 
persons authorized coverage to include the uniformed services that are 
not armed forces. A final rule implementing this change was published 
in the Federal Register on September 30, 1994. The statute was again 
amended by Section 705 of the NDAA for FY 2008 which authorized the 
expansion of persons eligible for the CHCBP under 10 U.S.C. 1078a to 
include any person specified by regulation prescribed by the Secretary 
who was authorized coverage under 10 U.S.C. chapter 55 and who loses 
that eligibility. The proposed rule to implement this change was 
published in the Federal Register on November 27, 2009. The intent of 
the proposed rule and this final rule is to specify that any person who 
is currently authorized coverage under 10 U.S.C. chapter 55 or 10 
U.S.C. 1145(a) and any person who may in the future be authorized 
coverage under chapter 55 of 10 U.S.C. or 10 U.S.C. 1145(a) and who 
loses that eligibility shall be authorized coverage under the CHCBP.
    Currently, CHCBP provides coverage for certain active duty (AD) 
service members and their family members as well as RC members and 
their families. The coverage period is up to 36 months after the date 
on which the person first ceases to be covered under his or her 
respective program eligibility. However, for RC members the coverage is 
for 18 months from either separation from AD or when coverage under the 
Transitional Assistance Management Program (TAMP) (10 U.S.C. 1145(a)) 
ends.
    The 2008 change to 10 U.S.C. 1078a expands CHCBP to all who the 
Secretary specifies in regulation who lose entitlement or eligibility 
to health care services under 10 U.S.C. chapter 55 Therefore, members 
or former members of the RC, such as TRICARE Reserve Select under 10 
U.S.C. 1076d or TRICARE Retired Reserve under 10 U.S.C. Section 1076e 
coverage under CHCBP will now run for 18 months after the date the 
member ceases to be eligible for benefits under their respective 
Reserve program's eligibility. The rule also standardizes the number of 
days that a written election by an eligible beneficiary must be made to 
sixty (60) days after loss of entitlement or eligibility. Previously, 
those losing eligibility for TRICARE Reserve Select had only thirty 
(30) days to elect CHCBP coverage. The rule clarifies that individual 
locked out of other TRICARE plans per the other TRICARE program rules 
are not eligible to purchase CHCBP.

II. Public Comments

    The proposed rule was published in the Federal Register on November 
27, 2009 (74 FR 62271), for a 60-day comment period. We received 
comments from one individual. We thank the commenter for his comments. 
Specific matters raised are summarized below.
    Comment: One commenter said the final changes to the CHCBP could be 
extremely beneficial to current and former service members, but that 
eligibility for health care for National Guard/RC members after the 
member ceases to be entitled to care under 10 U.S.C. 1074(a) (AD) or 10 
U.S.C. 1145(a) (TAMP) should be extended to at least 24 months to 
maximize the opportunity for care. The commenter noted many health 
issues that service members are experiencing in theater need more time 
to be fully understood by the member and to be officially diagnosed. By 
extending an additional six months, service members who may be in 
denial about health issues or who may be having trouble transitioning 
to ``civilian'' life would have more time to obtain medical and dental 
care.
    Response: The period of CHCBP eligibility after a period of AD or 
TAMP is limited by statute to 18 months. However, the 6 months of TAMP 
plus the 18 months of CHCBP allows the member the opportunity for 24 
months of care.
    Comment: One comment asked for clarity as to how long a ``specific 
and limited period of time'' CHCBP can continue.
    Response: Eligibility timeframes for CHCBP vary by beneficiary 
category and are outlined in 32 CFR 199.20(d)(1).
    Comment: One comment asked who would be considered a ``certain 
former spouse'' who is eligible for CHCBP.
    Response: Eligibility for unremarried former spouses is outlined in 
32 CFR 199.20(d)(1)(iii).

III. Provisions of Final Rule

    This rule expands eligibility to purchase CHCBP coverage for any 
beneficiary that loses entitlement or eligibility for medical care 
under 10 U.S.C. chapter 55 or 10 U.S.C. 1145(a), subject to the 
coverage limits of 10 U.S.C. 1078a.
    The final rule incorporates a number of revisions from the proposed 
rule to clarify the expanded coverage adopted by Congress in section 
705 of the NDAA for FY 2008 to ensure that all future beneficiaries 
under 10 U.S.C. chapter 55 or 10 U.S.C. 1145 who lose eligibility for 
care under those parts will be eligible to purchase CHCBP. For example 
in relation to coverage of RC personnel and their family members, the 
children of RC personnel who are covered dependent children under TRS 
and who reach the coverage age limit will have the same CHCBP 
eligibility as their counterparts who are children of AD personnel. As 
another example, a surviving spouse and child of a RC member who dies 
and who were covered by TRR will have the opportunity to obtain CHCBP 
coverage for up to three years after TRR coverage ends.

Administrative Changes

    This final rule provides for improved administration of CHCBP by: 
Allowing the Department of Defense and the other uniformed services the 
ability to delegate to a designee the responsibility for notifying 
persons eligible to receive health benefits under the CHCBP; requiring 
supporting documentation on any change in status that would make a 
child eligible for CHCBP; allowing notification of a former spouse's 
potential eligibility for CHCBP to be made to the CHCBP contractor by 
the member, former member, or former spouse; establishing a 14-day 
period within which the CHCBP contractor must advise former spouses of 
their potential eligibility for CHCBP; and discontinuing the 
requirement that CHCBP premium rates be published annually but, 
instead, requiring that the premium rates be published whenever a 
change in rate occurs. There have been no changes in this final rule 
from the proposed rule on these administrative matters.

[[Page 57639]]

    This final rule also makes minor editorial changes in an attempt to 
improve understanding of CHCBP program requirements and processes, 
including making grammatical improvements in the text of Sec.  199.20. 
There have been a few minor changes in this final rule from the 
proposed rule on these editorial matters. These include reference to 
the ``TRICARE Standard program'' vice the TRICARE basic program; 
reference to the ``CHCBP contractor'' vice the ``Third Party 
Administrator;'' and reference to members of the ``uniformed services'' 
where the term ``armed forces'' was inadvertently used. Finally, the 
final rule includes a conforming change to Sec.  199.24, deleting the 
paragraph that addressed the relationship between TRS and the CHCBP. 
That relationship is not covered by the revised provisions in Sec.  
199.20, which governs the CHCBP.
    This final rule also contains administrative changes to update 
information regarding the current CHCBP and TRICARE programs as 
follows: Updates the ``CHAMPUS'' (Civilian Health and Medical Program 
of the Uniformed Services) program name to ``TRICARE'' when 
appropriate; updates the Department of Defense agency name from 
``OCHAMPUS'' (the Office of CHAMPUS) to ``TRICARE Management Activity'' 
(TMA); replaces the reference ``Third Party Administrator'' with 
``CHCBP contractor'' to make it consistent with the ``contractor'' term 
used for TMA programs; updates ``military health services system'' with 
``Military Health System;'' and updates information regarding the 
enrollment process both to require the use of the enrollment 
applications or DD Form as designated by the Director, TRICARE as well 
as the documentation required to verify an applicant's eligibility for 
enrollment.
    This final rule contains administrative changes to other paragraphs 
of Title 32 Code of Federal Regulations, specifically in Sec.  199.20, 
by: Changing the title of paragraph (n) of this section ``Peer Review 
Organization Program'' to ``Quality and Utilization Review Peer Review 
Organization Program;'' changing the title of the program in paragraph 
(p)(2)(ii) from ``Active Duty Dependents Dental Plan'' to ``TRICARE 
Dental Program;'' and by adding to that same paragraph the ``TRICARE 
Retiree Dental Program'' under Sec.  199.22 as a special program that 
is not available to participants in the CHCBP. In addition, this final 
rule deletes paragraph (p)(3) in its entirety, as that subpart 
referenced two demonstration projects that are no longer in existence 
and therefore no longer available to CHCBP participants: The ``Home 
Health Care Demonstration'' and the ``Home Health Care--Case Management 
Demonstration.'' There have been no changes in this final rule from the 
proposed rule on these references.

IV. Regulatory Procedures

Executive Order 12866, ``Regulatory Planning and Review'' and Public 
Law 96-354, ``Regulatory Flexibility Act'' (5 U.S.C. 601)

    Executive Order 12866 requires that a comprehensive regulatory 
impact analysis be performed on any economically significant regulatory 
action, defined as one that would result in an annual effect of $100 
million or more on the national economy or which would have other 
substantial 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 
which would have a significant impact on a substantial number of small 
entities. This rule is not an economically significant regulatory 
action and will not have a significant impact on a substantial number 
of small entities for purposes of the RFA, thus this final rule is not 
subject to any of these requirements.

Sec. 202, Public Law 104-4, ``Unfunded Mandates Reform Act''

    This rule does not contain unfunded mandates. It does not contain a 
Federal mandate that may result in the expenditure by State, local, and 
tribal governments, in aggregate, or by the private sector, of $100 
million or more in any one year.

Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3511)

    This rule will not impose additional information collection 
requirements on the public. OMB previously cleared the collection 
requirements under OMB Control Number 0704-0364.

Executive Order 13132, ``Federalism''

    We have examined the impact(s) of the rule under Executive Order 
13132, and it does not have policies that have federalism implications 
that would 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, therefore, consultation with State and local officials is 
not required.

List of Subjects in 32 CFR Part 199

    Claims, Dental health, Health care, Health insurance, Individuals 
with disabilities, Military personnel.

    Accordingly, 32 CFR part 199 is amended as follows:

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. Section 199.20 is revised to read as follows:


Sec.  199.20  Continued Health Care Benefit Program (CHCBP).

    (a) Purpose. The CHCBP is a premium-based temporary health care 
coverage program that will be available to beneficiaries who meet the 
eligibility and enrollment criteria as set forth in paragraph (d)(1) of 
this section. The CHCBP is not part of the TRICARE program. However, as 
set forth in this section, it functions under similar rules and 
procedures of the TRICARE Standard program. Because the purpose of the 
CHCBP is to provide a continuation health care benefit for the 
Department of Defense and the other uniformed services (National 
Oceanic and Atmospheric Administration (NOAA), Public Health Service 
(PHS), and Coast Guard) beneficiaries losing eligibility, it will be 
administered so that it appears, to the maximum extent possible, to be 
part of the TRICARE Standard program. Medical coverage under this 
program will be the same as the benefits payable under the TRICARE 
Standard program. However, unlike the Standard program there is a cost 
for enrollment to the CHCBP and these premium costs are payable by 
enrollees before any care may be provided.
    (b) General provisions. Except for any provisions the Director of 
the TRICARE Management Activity may exclude, the general provisions of 
Sec.  199.1 shall apply to the CHCBP as they do to TRICARE.
    (c) Definitions. Except as may be specifically provided in this 
section, to the extent terms defined in Sec.  199.2 are relevant to the 
administration of the CHCBP, the definitions contained in that section 
shall apply to the CHCBP as they do to the TRICARE Standard program.
    (d) Eligibility and enrollment. (1) Eligibility, Enrollment in the 
CHCBP is open to any individual, except as noted in this section, who:
    (i) Ceases to meet the requirements for eligibility under 10 U.S.C. 
chapter 55 or 10 U.S.C. 1145, and
    (ii) Who on the day before they cease to meet the eligibility 
requirements for

[[Page 57640]]

such care they were covered under a health benefit plan under 10 U.S.C. 
chapter 55 or transitional healthcare under 10 U.S.C. 1145, and
    (iii) Who would otherwise not be eligible for any benefits under 10 
U.S.C. chapter 55 or 10 U.S.C. 1145 except for CHCBP.
    (2) Exceptions. The following individuals are not eligible to 
enroll in CHCBP:
    (i) Members of uniformed services, who are discharged or released 
from active duty either voluntarily or involuntarily under conditions 
that are adverse.
    (ii) Individuals who lost their eligibility or entitlement to care 
under 10 U.S.C. chapter 55 or 10 U.S.C. 1145 before October 1, 1994.
    (iii) Individuals who are locked out of other TRICARE programs per 
that program's requirements.
    (3) Effective date. Eligibility in the CHCBP is limited to 
individuals who lost their entitlement to benefits under the MHS on or 
after October 1, 1994. The effective date of their coverage under CHCBP 
shall begin on the day after they cease to be eligible for care under 
10 U.S.C. chapter 55 or 10 U.S.C. 1145.
    (4) Notification of eligibility.
    (i) The Department of Defense and the other uniformed services 
(National Oceanic and Atmospheric Administration (NOAA), Public Health 
Service (PHS), and Coast Guard) will notify persons in the uniformed 
services eligible to receive health benefits under the CHCBP. In the 
case of a member who becomes (or will become) eligible for continued 
coverage, the Department of Defense shall notify the member of their 
rights for coverage as part of pre-separation counseling conducted 
under 10 U.S.C. 1142.
    (ii) In the case of a dependent of a member or former member who 
become eligible for continued coverage under paragraph (d)(1)(ii) of 
this section:
    (A) The member or former member may submit to the CHCBP contractor 
a notice with supporting documentation of the dependent's change in 
status (including the dependent's name, address, and such other 
information needed); and
    (B) The CHCBP contractor, within fourteen (14) days after receiving 
such information, will inform the dependent of the dependent's rights 
under 10 U.S.C. 1142.
    (iii) In the case of a former spouse of a member or former member 
who becomes eligible for continued coverage, the member, former member 
or former spouse may submit to the CHCBP contractor a notice of the 
former spouse's change in status. The CHCBP contractor within fourteen 
(14) days after receiving such information will notify the individual 
of their potential eligibility for CHCBP.
    (5) Election of coverage. In order to obtain coverage under the 
CHCBP, a written election by the eligible beneficiary must be made 
within a prescribed time period.
    (i) In the case of a member discharged or released from active duty 
or full-time National Guard duty (whether voluntarily or 
involuntarily), or a RC member formerly eligible for care under 10 
U.S.C. chapter 55, the written election shall be submitted to the CHCBP 
contractor before the end of the 60-day period beginning on the later 
of:
    (A) The date of the discharge or release of the member; or
    (B) The date that the period of transitional health care applicable 
to the member under 10 U.S.C. 1145(a) ends; or
    (C) The date the member receives the notification required in 
paragraph (d)(3) of this section.
    (ii) In the case of a child who ceases to meet the requirements for 
being an unremarried dependent child of a member or former member under 
10 U.S.C. 1072(2)(D) or an unmarried dependent of a member or former 
member of the uniformed services under 10 U.S.C. 1072(2)(I), the 
written election shall be submitted to the CHCBP contractor before the 
end of the 60-day period beginning on the later of:
    (A) The date that the dependent ceases to meet the definition of a 
dependent under 10 U.S.C. 1072(2)(D) or 10 U.S.C. 1072(2)(I); or
    (B) The date that the dependent receives the notification required 
in paragraph (d)(3) of this section,
    (iii) In the case of former spouse of a member or former member, 
the written election shall be submitted to the CHCBP contractor before 
the end of the 60-day period beginning on the date as of which the 
former spouse first ceases to meet the requirements for being 
considered a dependent under 10 U.S.C. 1072(2).
    (iv) In the case of an unmarried surviving spouse of a member or 
former member of the uniformed services who on the day before the death 
of the member or former member was covered under 10 U.S.C. chapter 55 
or 10 U.S.C. 1145(a), the written election shall be submitted to the 
CHCBP contractor within 60 days of the date of the member or former 
member's death.
    (v) A member of the uniformed services who is eligible for 
enrollment under paragraph (d)(1) of this section may elect self-only 
or family coverage. Family members who may be included in such family 
coverage are the spouse and children of the member.
    (vi) All other categories eligible for enrollment under paragraph 
(d)(1) of this section must elect self-only coverage.
    (6) Enrollment. To enroll in the CHCBP, an eligible individual must 
submit the completed enrollment form designated by the Director, 
TRICARE as well as any documentation as requested on the enrollment 
form to verify the applicant's eligibility for enrolling in CHCBP, and 
payment to cover the quarter's premium. The CHCBP contractor may 
request additional information and documentation to confirm the 
applicant's eligibility for CHCBP.
    (7) Period of coverage. Except as noted below CHCBP coverage may 
not extend beyond 18 months from the date the individual becomes 
eligible for CHCBP. Although beneficiaries have sixty (60) days to 
elect coverage under the CHCBP, upon enrolling, the period of coverage 
must begin the day after entitlement or eligibility to a military 
health care plan ends as though no break in coverage had occurred 
notwithstanding the date the enrollment form with any applicable 
premium is submitted.
    (i) Exceptions:
    (A) In the case of a child of a member or former member, the date 
which is 36 months after the date on which the person first ceases to 
meet the requirements for being considered an unmarried dependent child 
under 10 U.S.C. 1072(2)(D) or 10 U.S.C. 1072(2)(I).
    (B) In the case of an unremarried former spouse (as this term is 
defined in 10 U.S.C. 1072(2)(G) or (H)) of a member or former member, 
the date which is 36 months after the later of:
    (1) The date on which the final decree of divorce, dissolution, or 
annulment occurs; or
    (2) If applicable, the date the one-year extension of dependency 
under 10 U.S.C. 1072(2)(H) expires.
    (C) In the case of an unremarried surviving spouse (widow or 
widower) (under 10 U.S.C. 1072(2)(B) or (C)) of a member or former 
member of the uniformed services who is not otherwise eligible for care 
under 10 U.S.C. chapter 55, the date which is 36 months after the date 
the surviving spouse becomes ineligible under 10 U.S.C chapter 55 or 10 
U.S.C. 1145(a).
    (D) In the case of a former spouse of a retiree whose marriage was 
dissolved after the member retired from the service, the period of 
coverage under the

[[Page 57641]]

CHCBP is unlimited, if the former spouse:
    (1) Has not remarried before the age of 55 after the marriage to 
the former member was dissolved; and
    (2) Was enrolled in the CHCBP or TRICARE as the dependent of a 
retiree during the 18-month period before the date of the divorce, 
dissolution, or annulment; and
    (3) Is receiving a portion of the retired or retainer pay of a 
member or former member or an annuity based on the retainer pay of the 
member; or
    (4) Has a court order for payment of any portion of the retired or 
retainer pay or has a written agreement (whether voluntary or pursuant 
to a court order) which provides for an election by the member or 
former member to provide an annuity to the former spouse.
    (E) For the beneficiary who becomes eligible for the CHCBP by 
ceasing to meet the requirements for being considered an unmarried 
dependent child of a member or former member, health care coverage may 
not extend beyond the date which is 36 months after the date the member 
becomes ineligible for medical and dental care under 10 U.S.C. 1074(a) 
and any transitional health care under 10 U.S.C. 1145(a).
    (e) CHCBP benefits.
    (1) In general. Except as provided in paragraph (e)(2) of this 
section, the provisions of Sec.  199.4 shall apply to the CHCBP as they 
do to TRICARE.
    (2) Exceptions. The following provisions of Sec.  199.4 are not 
applicable to the CHCBP:
    (i) Section 199.4(a)(2) concerning eligibility.
    (ii) All provisions regarding requirements to use facilities of the 
uniformed services because CHCBP enrollees are not eligible to use 
those facilities.
    (3) Beneficiary liability. For purposes of TRICARE deductible and 
cost-sharing requirements and catastrophic cap limits, amounts 
applicable to the category of beneficiaries to which the CHCBP enrollee 
last belonged shall continue to apply, except that for separating 
active duty members, amounts applicable to dependents of active duty 
members shall apply.
    (f) Authorized providers. The provisions of Sec.  199.6 shall apply 
to the CHCBP as they do to TRICARE Standard.
    (g) Claims submission, review, and payment. The provisions of Sec.  
199.7 shall apply to the CHCBP as they do to TRICARE Standard except no 
provisions regarding nonavailability statements shall apply.
    (h) Double coverage. The provisions of Sec.  199.8 shall apply to 
the CHCBP as they do to TRICARE Standard.
    (i) Administrative remedies for fraud, abuse, and conflict of 
interest. The provisions of Sec.  199.9 shall apply to the CHCBP as 
they do to TRICARE Standard.
    (j) Appeal and hearing procedures. The provisions of Sec.  199.10 
shall apply to the CHCBP as they do to TRICARE Standard.
    (k) Overpayments recovery. The provisions of Sec.  199.11 shall 
apply to the CHCBP as they do to TRICARE Standard.
    (l) Third party recoveries. The provisions of Sec.  199.12 shall 
apply to the CHCBP as they do to TRICARE Standard.
    (m) Provider reimbursement methods. The provisions of Sec.  199.14 
shall apply to the CHCBP as they do to TRICARE Standard.
    (n) Quality and Utilization Review Peer Review Organization 
Program. The provisions of Sec.  199.15 shall apply to the CHCBP as 
they do to TRICARE Standard.
    (o) Preferred provider organization programs available. Any 
preferred provider organization program under this part that provides 
for reduced cost sharing for using designated providers, such as the 
``TRICARE Extra'' option under Sec.  199.17, shall be available to 
participants in the CHCBP as it is to TRICARE Standard beneficiaries.
    (p) Special programs not applicable.
    (1) In general. Special programs established under this Part that 
are not part of the TRICARE Standard program established pursuant to 10 
U.S.C. 1079 and 1086 are not, unless specifically provided in this 
section, available to participants in the CHCBP.
    (2) Examples. The special programs referred to in paragraph (p)(1) 
of this section include but are not limited to:
    (i) The Extended Care Health Option under Sec.  199.5;
    (ii) The TRICARE Dental Program or Retiree Dental Program under 
Sec.  199.13 and 199.22 respectively;
    (iii) The Supplemental Health Care Program under Sec.  199.16;
    (iv) The TRICARE Program under Sec.  199.17, except for TRICARE 
Standard and Extra programs under that section; and
    (v) The Uniform HMO benefit under Sec.  199.18.
    (q) Premiums.
    (1) Rates. Premium rates will be established by the Assistant 
Secretary of Defense (Health Affairs) for two rate groups--individual 
and family. Eligible beneficiaries will select the level of coverage 
they require at the time of initial enrollment (either individual or 
family) and pay the appropriate premium payment. The rates are based on 
Federal Employees Health Benefits Program employee and agency 
contributions required for a comparable health benefits plan, plus an 
administrative fee. The administrative fee, not to exceed ten percent 
of the basic premium amount, shall be determined based on actual 
expected administrative costs for administration of the program. 
Premiums may be revised annually and shall be published when the 
premium amount is changed. Premiums will be paid by enrollees 
quarterly.
    (2) Effects of failure to make premium payments. Failure by 
enrollees to submit timely and proper premium payments will result in 
denial of continued enrollment and denial of payment of medical claims. 
Premium payments that are late thirty (30) days or more past the start 
of the quarter for which payment is due will result in the termination 
of beneficiary enrollment. Beneficiaries denied continued enrollment 
due to lack of premium payments will not be allowed to reenroll. In 
such a case, benefit coverage will cease at the end of the ninety (90) 
day period for which a premium payment was received. Enrollees will be 
held liable for medical costs incurred after losing eligibility.
    (r) Procedures. The Director, TRICARE Management Activity, may 
establish other rules and procedures for the administration of the 
CHCBP.

0
3. Section 199.24 is amended by removing and reserving paragraph (e) to 
read as follows:


Sec.  199.24  TRICARE Reserve Select.

* * * * *
    (e) [Reserved]
* * * * *

    Dated: August 24, 2011.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2011-23760 Filed 9-15-11; 8:45 am]
BILLING CODE 5001-06-P