[Federal Register Volume 71, Number 241 (Friday, December 15, 2006)]
[Notices]
[Page 75508]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 06-9719]


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

DEPARTMENT OF DEFENSE

Office of the Secretary

[No. DoD-2006-HA-0180]


Submission for OMB Review; Comment Request

ACTION: Notice.

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

    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 (44 U.S.C. Chapter 35).

DATES: Consideration will be given to all comments received by January 
16, 2007.
    Title, Form, and OMB Number: TRICARE Prime Enrollment/Disenrollment 
Applications; DD Forms 2876 and 2877; OMB Number 0720-0008.
    Type of Request: Extension.
    Number of Respondents: 72,905.
    Responses Per Respondent: 1.
    Annual Responses: 72,905.
    Average Burden Per Response: 20 minutes (DD Form 2876) and 5 
minutes (DD Form 2877).
    Annual Burden Hours: 22,316.
    Needs and Uses: This information is collected in accordance with 
the National Defense Authorization for Fiscal Year 2001 (Pub. L. 106-
398), section 723(b)(E). These collection instruments serve as 
applications for enrollment in the Primary Care Manager (PCM) Change 
and disenrollment from the Department of Defense's TRICARE Prime 
programs established in accordance with Title 10 U.S.C. 1099 (which 
calls for a healthcare enrollment system). Monthly payment options for 
retiree enrollment fees for TRICARE Prime are established in accordance 
with Title 10 U.S.C. 1097a(c). The information collected on the TRICARE 
Prime Enrollment Application/PCM Change form provides the necessary 
data to determine beneficiary eligibility, to identify the selection of 
a health care option, and to change the designated PCM when the 
beneficiary is relocating or merely requests a local PCM change. The 
information collected on the TRICARE Prime disenrollment form provides 
the necessary data to disenroll a beneficiary from TRICARE Prime. The 
disenrollment application is needed to implement disenrollment from 
TRICARE Prime, TRICARE Prime Remote or the Uniformed Services Family 
Health Plan as requested by the enrollee. Failure to provide 
information will result in continued enrollment and beneficiaries' 
responsibility for payment of an enrollment fee.
    Affected Public: Individuals or households.
    Frequency: On Occasion.
    Respondent's Obligation: Required to Obtain or Retain Benefits.
    OMB Desk Officer: Mr. John Kraemer.
    Written comments and recommendations on the proposed information 
collection should be sent to Mr. Kraemer at the Office of Management 
and Budget, DoD Health Desk Officer, Room 10102, New Executive Office 
Building, Washington, DC 20503.
    You may also submit comments, identified by docket number and 
title, by the following method:
    <bullet> Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.pInstructions: 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.
    DoD Clearance Officer: Ms. Patricia Toppings.
    Written requests for copies of the information collection proposal 
should be sent to Ms. Toppings at WHS/ESD/Information Management 
Division, 1777 North Kent Street, RPN, Suite 11000, Arlington, VA 
22209-2133.

    Dated: December 8, 2006.
Patricia L. Toppings,
Alternate OSD Federal Register, Liaison Officer, Department of Defense.
[FR Doc. 06-9719 Filed 12-14-06; 8:45 am]
BILLING CODE 5001-06-M