[Federal Register Volume 81, Number 39 (Monday, February 29, 2016)]
[Notices]
[Pages 10222-10223]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-04328]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DoD-2015-HA-0132]


Submission for OMB Review; Comment Request

ACTION: Notice.

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SUMMARY: The Department of Defense has submitted to OMB for clearance, 
the following proposal for collection of information under the 
provisions of the Paperwork Reduction Act.

DATES: Consideration will be given to all comments received by March 
30, 2016.

FOR FURTHER INFORMATION CONTACT: Fred Licari, 571-372-0493.

SUPPLEMENTARY INFORMATION: 
    Title, Associated Form and OMB Number: DD Form 2876, TRICARE Prime 
Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form, 
OMB Control Number 0720-0008.
    Type of Request: Revision.
    Number of Respondents: 148,033.
    Responses per Respondent: 1.
    Annual Responses: 148,033.

[[Page 10223]]

    Average Burden per Response: 15 minutes.
    Annual Burden Hours: 37,008.
    Needs and Uses: The information collection requirement is necessary 
to obtain the TRICARE beneficiary's personal information needed to: (1) 
Complete his/her enrollment into TRICARE Prime health plan, (2) change 
the beneficiary's enrollment (new Primary Care Manager, enrolled 
region, add/drop a dependent, etc.), or (3) dis-enroll the beneficiary. 
All TRICARE beneficiaries have the option of enrolling, changing their 
enrollment or dis-enrolling using the DD Form 2876, the Beneficiary Web 
Enrollment (BWE) portal, or by calling their regional Managed Care 
Support Contractor (MCSC). Although the telephonic enrollment/change is 
the preferred method by the large majority of beneficiaries, many 
beneficiaries prefer using the form to document their enrollment date 
and preferences.
    Affected Public: Individuals and households.
    Frequency: On occasion.
    Respondent's Obligation: Required to Obtain or Retain Benefits.
    OMB Desk Officer: Ms. Stephanie Tatham.
    Comments and recommendations on the proposed information collection 
should be emailed to Ms. Stephanie Tatham, DoD Desk Officer, at 
[email protected]. Please identify the proposed information 
collection by DoD Desk Officer and the Docket ID number and title of 
the information collection.
    You may also submit comments and recommendations, identified by 
Docket ID number and title, by the following method:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
    Instructions: All submissions received must include the agency 
name, Docket ID 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.
    DOD Clearance Officer: Mr. Frederick Licari.
    Written requests for copies of the information collection proposal 
should be sent to Mr. Licari at WHS/ESD Directives Division, 4800 Mark 
Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100.

    Dated: February 24, 2016.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2016-04328 Filed 2-26-16; 8:45 am]
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