[Federal Register Volume 84, Number 55 (Thursday, March 21, 2019)]
[Notices]
[Page 10481]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-05350]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DOD-2019-HA-0029]


Proposed Collection; Comment Request

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

ACTION: Information collection notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Office of the Assistant Secretary of Defense for Health Affairs 
announces a proposed public information collection and seeks public 
comment on the provisions thereof. Comments are invited on: 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; the accuracy of the agency's 
estimate of the burden of the proposed information collection; ways to 
enhance the quality, utility, and clarity of the information to be 
collected; and 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 May 20, 
2019.

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: Department of Defense, Office of the Chief 
Management Officer, Directorate for Oversight and Compliance, 4800 Mark 
Center Drive, Mailbox #24, Suite 08D09, Alexandria, VA 22350-1700.
    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.
    Any associated form(s) for this collection may be located within 
this same electronic docket and downloaded for review/testing. Follow 
the instructions at http://www.regulations .gov for submitting 
comments. Please submit comments on any given form identified by docket 
number, form number, and title.

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 the Defense Health 
Agency, TRICARE Health Plan Office, 8111 Gatehouse Road, Falls Church, 
VA 22042, ATTN: Ms. Shane Pham, or call 703-275-6249.

SUPPLEMENTARY INFORMATION: 
    Title; Associated Form; and OMB Number: TRICARE Prime Enrollment, 
Disenrollment, and Primary Care Manager (PCM) Change Form; DD Form 
2876; OMB Control Number 0720-0008.
    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) disenroll 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.
    Annual Burden Hours: 74,017.
    Number of Respondents: 148,033.
    Responses per Respondent: 1.
    Annual Responses: 148,033.
    Average Burden per Response: 30 minutes.
    Frequency: On occasion.
    Respondents are TRICARE beneficiaries choosing to enroll in TRICARE 
Prime for the first time, change their current enrollment, or disenroll 
using the DD Form 2876, instead of using the BWE web portal or calling 
their Managed Care Support Contractor. The completed form is used by 
the TRICARE Managed Care Support Contractors to formally update the 
enrollment, enrollment change or disenrollment. The beneficiary is 
notified via email or postcard, which refers them to the MilConnect 
website to confirm the enrollment/change. A beneficiary can also call 
their Managed Care Support Contractor to confirm the change.

    Dated: March 15, 2019.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2019-05350 Filed 3-20-19; 8:45 am]
 BILLING CODE 5001-06-P