[Federal Register Volume 77, Number 230 (Thursday, November 29, 2012)]
[Notices]
[Pages 71174-71175]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-28864]


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

DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID DoD-2012-HA-0145]


Proposed Collection; Comment Request

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs, DoD.

ACTION: Notice.

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

    In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995, the Office of the Assistant Secretary of Defense for 
Health Affairs announces the proposed extension of a public information 
collection and seeks public comment on the provisions thereof. Comments 
are invited on: (a) Whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information shall have practical utility; (b) the 
accuracy of the agency's estimate of the burden of the proposed 
information collection; (c) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (d) ways to minimize 
the burden of the information collection on respondents, including 
through the use of automated collection techniques or other forms of 
information technology.

DATES: Consideration will be given to all comments received by January 
28, 2013.

ADDRESSES: You may submit comments, identified by docket number and 
title, by any of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Federal Docket Management System Office, 4800 Mark 
Center Drive, East Tower, 2nd floor, Suite 02G09, Alexandria, VA 22350-
3100.
    Instructions: All submissions received must include the agency 
name, docket 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.

[[Page 71175]]


FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection or to obtain a copy of the proposal and 
associated collection instruments, please write to TRICARE Management 
Activity Program, Policy and Benefits Branch, ATTN: Mr. Mark Ellis, 
5111 Leesburg Pike, Suite 810, Falls Church, VA 22041-3206, or call 
703-681-0039.
    Title; Associated Form; and OMB Number: Continued Health Care 
Benefit Program, DD Form 2837; OMB Number 0720-TBD (previously cleared 
under OMB Control Number 0704-0364).
    Needs and Uses: The continuing information collection requirement 
is necessary for individuals to apply for enrollment in the Continued 
Health Care Benefit Program (CHCBP). The CHCBP is a program of 
temporary health care benefit coverage that is made available to 
eligible individuals who lose health care coverage under the Military 
Health System (MHS).
    Affected Public: Individuals or households.
    Annual Burden Hours: 625.
    Number of Respondents: 2,500.
    Responses per Respondent: 1.
    Average Burden per Response: .25 hours.
    Frequency: On occasion.

SUPPLEMENTARY INFORMATION: 

Summary of Information Collection

    Respondents are individuals who are or were beneficiaries of the 
Military Health System (MHS) and who desire to enroll in the CHCBP 
following their loss of eligibility or entitlement to health care 
coverage in the MHS. These beneficiaries include any person formerly 
eligible for care from the MHS according to Chapter 55 or Section 1145a 
of Title 10, United States Code.
    In order to be eligible for health care coverage under CHCBP, an 
individual must first enroll in CHCBP. DD Form 2837 is used as the 
information collection vehicle for that enrollment. The CHCBP is a 
legislatively mandated program and it is anticipated that the program 
will continue indefinitely. As such, the DoD is publishing this formal 
notice.

    Dated: November 26, 2012.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2012-28864 Filed 11-28-12; 8:45 am]
BILLING CODE 5001-06-P