Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 23479 

PART 41—VISAS: DOCUMENTATION 

OF NONIMMIGRANTS UNDER THE 

IMMIGRATION AND NATIONALITY 

ACT, AS AMENDED 

■ 1. The authority citation for section 41 

continues to read as follows: 

Authority: 8 U.S.C. 1104; Pub. L. 105–277, 

112 Stat. 2681–795 through 2681–801; 8 

U.S.C. 1185 note (section 7209 of Pub. L. 

108–458, as amended by section 546 of Pub. 

L. 109–295). 

■ 2. Section 41.122 is revised to read as 

follows: 

§ 41.122 Revocation of visas. 

(a) Grounds for revocation by consular 

officers. A consular officer, the 

Secretary, or a Department official to 

whom the Secretary has delegated this 

authority is authorized to revoke a 

nonimmigrant visa at any time, in his or 

her discretion. 

(b) Provisional revocation. A consular 

officer, the Secretary, or any Department 

official to whom the Secretary has 

delegated this authority may 

provisionally revoke a nonimmigrant 

visa while considering information 

related to whether a visa holder is 

eligible for the visa. Provisional 

revocation shall have the same force and 

effect as any other visa revocation under 

INA 221(i). 

(c) Notice of revocation. Unless 

otherwise instructed by the Department, 

a consular officer shall, if practicable, 

notify the alien to whom the visa was 

issued that the visa was revoked or 

provisionally revoked. Regardless of 

delivery of such notice, once the 

revocation has been entered into the 

Department’s Consular Lookout and 

Support System (CLASS), the visa is no 

longer to be considered valid for travel 

to the United States. The date of the 

revocation shall be indicated in CLASS 

and on any notice sent to the alien to 

whom the visa was issued. 

(d) Procedure for physically canceling 

visas. A nonimmigrant visa that is 

revoked shall be canceled by writing or 

stamping the word ‘‘REVOKED’’ plainly 

across the face of the visa, if the visa is 

available to the consular officer. The 

failure or inability to physically cancel 

the visa does not affect the validity of 

the revocation. 

(e) Revocation of visa by immigration 

officer. An immigration officer is 

authorized to revoke a valid visa by 

physically canceling it in accordance 

with the procedure described in 

paragraph (d) of this section if: 

(1) The alien obtains an immigrant 

visa or an adjustment of status to that of 

permanent resident; 

(2) The alien is ordered excluded from 

the United States under INA 236, as in 

effect prior to April 1, 1997, or removed 

from the United States pursuant to INA 

235; 

(3) The alien is notified pursuant to 

INA 235 by an immigration officer at a 

port of entry that the alien appears to be 

inadmissible to the United States, and 

the alien requests and is granted 

permission to withdraw the application 

for admission; 

(4) A final order of deportation or 

removal or a final order granting 

voluntary departure with an alternate 

order of deportation or removal is 

entered against the alien; 

(5) The alien has been permitted by 

DHS to depart voluntarily from the 

United States; 

(6) DHS has revoked a waiver of 

inadmissibility granted pursuant to INA 

212(d)(3)(A) in relation to the visa that 

was issued to the alien; 

(7) The visa is presented in 

connection with an application for 

admission to the United States by a 

person other than the alien to whom the 

visa was issued; 

(8) The visa has been physically 

removed from the passport in which it 

was issued; or 

(9) The visa has been issued in a 

combined Mexican or Canadian B–1/B– 

2 visa and border crossing identification 

card, and the immigration officer makes 

the determination specified in § 41.32(c) 

with respect to the alien’s Mexican 

citizenship and/or residence or the 

determination specified in § 41.33(b) 

with respect to the alien’s status as a 

permanent resident of Canada. 

PART 42—VISAS: DOCUMENTATION 

OF IMMIGRANTS UNDER THE 

IMMIGRATION AND NATIONALITY 

ACT, AS AMENDED 

■ 3. The authority citation for section 42 

continues to read as follows: 

Authority: 8 U.S.C. 1104 and 1182; Pub. L. 

105–277; Pub. L. 108–449; 112 Stat. 2681– 

795 through 2681–801; The Convention on 

Protection of Children and Co-operation in 

Respect of Intercountry Adoption (done at 

the Hague, May 29, 1993), S. Treaty Doc. 

105–51 (1998), 1870 U.N.T.S. 167 (Reg. No. 

31922 (1993)); The Intercountry Adoption 

Act of 2000, 42 U.S.C. 14901–14954, Pub. L. 

106–279. 

■ 4. Section 42.82 is revised to read as 

follows: 

§ 42.82 Revocation of visas. 

(a) Grounds for revocation by consular 

officers. A consular officer, the 

Secretary, or any Department official to 

whom the Secretary has delegated this 

authority is authorized to revoke an 

immigrant visa at any time, in his or her 

discretion. 

(b) Provisional revocation. A consular 

officer, the Secretary, or any Department 

official to whom the Secretary has 

delegated this authority may 

provisionally revoke an immigrant visa 

while considering information related to 

whether a visa holder is eligible for the 

visa. Provisional revocation shall have 

the same force and effect as any other 

visa revocation under INA 221(i). 

(c) Notice of revocation. Unless 

otherwise instructed by the Department, 

a consular officer shall, if practicable, 

notify the alien to whom the visa was 

issued that the visa was revoked or 

provisionally revoked. Regardless of 

delivery of such notice, once the 

revocation has been entered into the 

Department’s Consular Lookout and 

Support System (CLASS), the visa is no 

longer to be considered valid for travel 

to the United States. The date of the 

revocation shall be indicated in CLASS 

and on any notice sent to the alien to 

whom the visa was issued. 

(d) Procedure for physically canceling 

visas. An immigrant visa that is revoked 

shall be canceled by writing or stamping 

the word ‘‘REVOKED’’ plainly across the 

face of the visa, if the visa is available 

to the consular officer. The failure or 

inability to physically cancel the visa 

does not affect the validity of the 

revocation. 

Dated: April 18, 2011. 

Janice L. Jacobs, 

Assistant Secretary for Consular Affairs, 

Department of State. 

[FR Doc. 2011–10077 Filed 4–26–11; 8:45 am] 

BILLING CODE 4710–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[Docket ID: DOD–2011–HA–0029; RIN 0720– 

AB48] 

Civilian Health and Medical Program of 

the Uniformed Services (CHAMPUS); 

TRICARE Young Adult 

AGENCY: Office of the Secretary, DoD. 

ACTION: Interim final rule with comment 

period. 

SUMMARY: This interim final rule 

implements Section 702 of the Ike 

Skelton National Defense Authorization 

Act for Fiscal Year 2011 (NDAA for 

FY11). It establishes the TRICARE 

Young Adult (TYA) program to provide 

an extended medical coverage 

opportunity to most unmarried children 

under the age of 26 of uniformed 

services sponsors. The TRICARE Young 

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23480 Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 

Adult program is a premium-based 

program. 

DATES: This interim final rule is 

effective April 27, 2011. Written 

comments received at the address 

indicated below by June 27, 2011 will 

be considered and addressed in the final 

rule. 

ADDRESSES: You may submit comments, 

identified by docket number and or RIN 

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, 1160 Defense Pentagon, 

Washington, DC 20301–1160. 

Instructions: All submissions received 

must include the agency name and 

docket number or Regulatory 

Information Number (RIN) for this 

Federal Register document. The general 

policy for comments and other 

submissions from dependents of the 

public is to make these submissions 

available for public viewing on the 

Internet at http://regulations.gov as they 

are received without change, including 

any personal identifiers or contact 

information. 

FOR FURTHER INFORMATION CONTACT: 

Mark Ellis, TRICARE Management 

Activity, TRICARE Policy and 

Operations Directorate, telephone (703) 

681–0039. Questions regarding payment 

of specific claims under the TRICARE 

allowable charge method should be 

addressed to the appropriate TRICARE 

contractor. 

SUPPLEMENTARY INFORMATION: 

I. Introduction and Background 

The purpose of this interim final rule 

is to establish the TRICARE Young 

Adult program implementing Section 

702 of the Ike Skelton NDAA for FY 

2011 (Pub. L. 111–383) to provide 

medical coverage to unmarried children 

under the age of 26 who no longer meet 

the age requirements for TRICARE 

eligibility (age 21, or 23 if enrolled in a 

full-time course of study at an 

institution of higher learning approved 

by the Secretary of Defense), and who 

are not eligible for medical coverage 

from an eligible employer-sponsored 

plan (as defined in section 5000A(f)(2) 

of the Internal Revenue Code of 1986). 

If qualified, they can purchase TRICARE 

Standard/Extra or TRICARE Prime 

benefits coverage. The particular 

TRICARE plan available depends on the 

military sponsor’s eligibility and the 

availability of the TRICARE plan in the 

dependent’s geographic location. 

II. Provisions of the Rule Regarding the 

TRICARE Young Adult Program 

A. Establishment of the TRICARE 

Young Adult Program (paragraph 

199.26(a)). This paragraph describes the 

nature, purpose, statutory basis, scope, 

and major features of TRICARE Young 

Adult, a full cost, premium-based 

medical coverage program made 

available for purchase worldwide. TYA 

is similar to young adult coverage under 

the Patient Protection and Affordable 

Care Act, but reflects a number of 

differences between TRICARE and 

typical civilian health care plans. 

Among these is that TYA is a full cost 

premium based program; it is limited to 

unmarried dependent children; and the 

dependent child must not be eligible for 

medical coverage from an eligible 

employer-sponsored plan (an exclusion 

that does not expire on January 1, 2014, 

but is permanent). TRICARE Young 

Adult is codified in Title 10, United 

States Code, Section 1110b. 

The major features of the program 

include making coverage available for 

purchase at a premium which will 

represent the full cost, including 

reasonable administrative costs, as 

determined on an appropriate actuarial 

basis for coverage. There will be various 

premiums depending on whether the 

dependent’s sponsor is active duty, 

retired or eligible under another plan 

such as TRICARE Reserve Select or 

TRICARE Retired Reserve, and the adult 

dependent’s health coverage—TRICARE 

Standard or, for those eligible and 

where available, TRICARE Prime. The 

rules and procedures otherwise outlined 

in Part 199 of 32 CFR relating to the 

operation and administration of the 

TRICARE program based on the 

sponsor’s status and health coverage 

plan will apply for cost-shares, 

deductibles, and catastrophic caps upon 

purchasing TRICARE Young Adult 

coverage. Young adult dependents of 

members on active duty for more than 

30 days are eligible for benefits under 

the TRICARE ECHO program under 

section 199.5 of this Part. 

The TRICARE Dental Program 

(§ 199.13 of this Part) and the TRICARE 

Retiree Dental Program (§ 199.22 of this 

Part) are not included as part of TYA. 

Under TRICARE Young Adult, 

qualified young adult dependents may 

purchase individual TRICARE coverage 

by submitting a completed request in 

the appropriate format along with an 

initial payment of the applicable 

premium at the time of enrollment. 

When coverage becomes effective, a 

TRICARE Young Adult purchaser 

receives the TRICARE benefits 

according to the rules governing the 

TRICARE program that the enrollee 

qualified for and selected based on the 

uniformed services sponsor’s status 

(active duty, retired, Selected Reserve, 

or Retired Reserve) and the availability 

of a desired plan in his or her 

geographic location. The rules and 

procedures otherwise outlined in the 

TRICARE Regulation (Part 199) relating 

to the operation and administration of 

the TRICARE programs will apply for 

cost-shares, deductibles, and 

catastrophic caps upon purchasing 

TRICARE Young Adult coverage. The 

young adult dependent’s cost-shares, 

deductibles, and catastrophic caps will 

be based on the sponsor’s status (active 

duty, retired, Selected Reserve, or 

Retired Reserve) and whether the 

dependent has purchased TRICARE 

Standard/Extra or Prime coverage. 

TRICARE Young Adult dependents are 

provided access priority for care in 

military treatment facilities based on 

their uniformed services sponsor’s 

status and the selection of health plan. 

The Continued Health Care Benefits 

Program (see § 199.20) shall be made 

available to all young adult dependents 

after aging out of the TRICARE Young 

Adult program or who otherwise lose 

their eligibility for the TRICARE Young 

Adult program. 

B. Qualifications for TYA coverage 

(paragraph 199.26(b)). This paragraph 

defines the statutory conditions under 

which unmarried children qualify as 

young adult dependents under the 

TRICARE Young Adult program. To 

qualify as a young adult dependent, the 

dependent must be under the age of 26, 

not be otherwise eligible for another 

TRICARE program, and not be eligible 

for medical coverage from an eligible 

employer-sponsored plan (as defined in 

section 5000A(f)(2) of the Internal 

Revenue Code of 1986). The 

dependents’ sponsor is responsible for 

keeping the Defense Enrollment 

Eligibility Reporting System (DEERS) 

current with eligibility data through the 

sponsor’s Service personnel office. 

Using information from the DEERS, the 

managed care support contractors have 

the responsibility to validate a 

dependent’s qualifications to purchase 

TRICARE Young Adult coverage. 

C. TRICARE Young Adult premiums 

(paragraph 199.26(c)). Qualified young 

adult dependents are charged premiums 

for coverage under TRICARE Young 

Adult that represent the full cost of 

providing TRICARE benefits under this 

program, including the reasonable costs 

of administration of the program. The 

total annual premium amounts shall be 

determined by the Assistant Secretary of 

Defense for Health Affairs (ASD(HA)) 

using an appropriate actuarial basis and 

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Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 23481 

are established and updated annually, 

on a calendar year basis, by the 

ASD(HA) for qualified young adult 

dependents. 

TRICARE YOUNG ADULT PREMIUMS— 

CALENDAR YEAR 2011 

TRICARE program Monthly 

premium 

TRICARE Standard/Extra Plans $186 

TRICARE Prime Plans ............. 213 

A premium shall be charged for each 

individual qualified young adult 

dependent regardless of whether a 

sponsoring member has more than one 

young adult dependent child who 

qualifies or purchases coverage under 

the TRICARE Young Adult program. 

The cost shares for TRICARE Standard/ 

Extra or Prime programs in which the 

adult child is enrolled shall be based on 

the status of the dependent’s sponsor. 

Because of the differences in cost-shares 

among the programs and status of the 

sponsor, there will be a different 

premium for TRICARE Standard and 

TRICARE Prime. Premiums are to be 

paid monthly. The monthly rate for each 

month of a calendar year is one-twelfth 

of the annual rate for that calendar year. 

The appropriate actuarial basis used 

for calculating premium rates shall be 

one that most closely approximates the 

actual cost of providing care to the same 

demographic population as those 

enrolled in TRICARE Young Adult as 

determined by the ASD(HA). TRICARE 

Young Adult premiums shall be based 

on the actual costs of providing benefits 

to TRICARE Young Adult dependents 

during the preceding years if the 

population of Young Adult dependents 

enrolled in TRICARE Young Adult is 

large enough during those preceding 

years to be considered actuarially 

appropriate. Until such time that actual 

costs from those preceding years 

become available, TRICARE Young 

Adult premiums shall be based on the 

actual costs during the preceding 

calendar years for providing benefits to 

the population of dependents over the 

age 21 up to age of 26 in order to make 

the underlying group actuarially 

appropriate. An adjustment may be 

applied to cover overhead costs for 

administration of the program by the 

government. Additionally, premium 

adjustments may be made to cover the 

prospective costs of any significant 

program changes. 

D. Procedures (paragraph 199.26(d)). 

The Director, TRICARE Management 

Activity (TMA) will establish 

procedures for administration of TYA. 

These will include procedures to 

purchase individual coverage, such as a 

request in an approved format, along 

with an initial payment of the 

applicable premium. Applicants must 

also certify that they meet the statutory 

qualifications to purchase coverage 

under this program. Additional 

procedures will be established for a 

qualified young adult dependent to 

purchase TRICARE Young Adult 

coverage with an effective date 

immediately following the last effective 

date of coverage under which they 

previously qualified in another 

TRICARE program. 

There will be open enrollment so that 

a qualified young adult dependent may 

purchase TRICARE Young Adult 

coverage at any time. The effective date 

of coverage for TRICARE Standard will 

coincide with the first day of a month 

after the date the application and 

required payment is received. The 

effective date of coverage for TRICARE 

Prime will be first day of the second 

month after the month in which 

application and required payment is 

received. There will be a limited period 

for retroactive coverage. A qualified 

young adult dependent may elect to 

start coverage under the TRICARE 

Standard plan effective with the 

statutory start date of January 1, 2011, 

if the dependent was eligible as of that 

date. If retroactive coverage is elected 

then retroactive premiums must be paid 

back to the statutory start date of 

January 1, 2011. If no retroactive 

coverage is elected or the retroactive 

premiums are not paid within the time 

prescribed, then coverage will not be 

retroactive and coverage will apply only 

prospectively beginning on the first day 

of the month after the date of the 

application. There shall be no 

retroactive coverage offered under any 

TRICARE Prime plan. No purchase of 

retroactive coverage may take place after 

September 30, 2011. 

With respect to termination of 

coverage, a loss of eligibility or 

entitlement for medical benefits of the 

sponsor will result in termination of 

coverage for the dependent’s TRICARE 

Young Adult coverage on the same date 

as the sponsor, unless otherwise 

authorized. Upon the death of an active 

duty sponsor, young adult age 

dependents may purchase TYA 

coverage up to the age of 26. If a 

Selected Reserve (Sel Res) or Retired 

Reserve member ends TRICARE Reserve 

Select (TRS) or TRICARE Retired 

Reserve (TRR) coverage, respectively, 

eligibility for the young adult dependent 

to purchase coverage under TRICARE 

Young Adult also ends. If a Sel Res 

sponsor dies while enrolled in TRS, the 

otherwise eligible adult age dependent 

can purchase TYA coverage up to 

6 months after the death of the sponsor. 

If a Retired Reserve sponsor dies while 

enrolled in TRR, the otherwise eligible 

young adult dependent may continue to 

purchase TYA coverage until the date 

on which the deceased sponsor would 

have turned age 60. If the Retired 

Reserve sponsor was not enrolled in 

TRR at the time of death, there is no 

eligibility to purchase TYA coverage 

until the sponsor would have turned age 

60. At that point, the young adult 

dependent qualifies as a dependent of a 

deceased retired sponsor and can 

purchase coverage up to the age of 26. 

Coverage will terminate whenever a 

dependent ceases to meet the 

qualifications for the program. Claims 

will be denied effective with the 

termination date. In addition, covered 

dependents may terminate coverage at 

any time by submitting a completed 

request in the appropriate format. 

Dependents whose coverage under 

TRICARE Young Adult terminates for 

failure to pay premiums in accordance 

with program requirements will not be 

allowed to purchase coverage again 

under TRICARE Young Adult for a 

period of one year following the date of 

their coverage termination. This 

ineligibility period shall be known as a 

‘‘lockout’’ period. A request for a waiver 

of the ‘‘lockout’’ period may be granted 

by the Director, TRICARE Management 

Activity, based on extraordinary 

circumstances beyond the control of the 

adult dependent which resulted in 

inability to make payments in 

accordance with program requirements. 

The Director may allow a 90-day grace 

period for payment to be made. 

However, if payment is not made by the 

90th day, then coverage will be deemed 

to have terminated as of the last day of 

the month in which an appropriate 

payment was made and no claims may 

be paid for care rendered after the date 

of termination. Upon termination of 

eligibility to purchase TYA coverage, 

qualified dependents may purchase 

coverage under the Continued Health 

Care Benefit Program for up to 36 

months except if locked out of TYA. 

Upon application and payment of 

appropriate premiums, a young adult 

dependent who has already purchased 

coverage under any of the plans offered 

under TYA may change to another 

TRICARE program for which the 

dependent is eligible. Eligibility is based 

on the sponsor’s status and the 

dependent’s geographic location. 

E. Preemption of State laws 

(paragraph 199.26(e)). This paragraph 

provides that the preemptions of State 

and local laws established for the 

TRICARE program also apply to 

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23482 Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 

TRICARE Young Adult. Any State or 

local law or regulation pertaining to 

health insurance, prepaid health plans, 

or other health care delivery, 

administration, and financing methods 

is preempted and does not apply in 

connection with TRICARE Young Adult. 

F. Administration (paragraph 

199.26(f)). This paragraph provides that 

the Director, TRICARE Management 

Activity, may establish other 

administrative processes and 

procedures necessary for the effective 

administration of TRICARE Young 

Adult. 

III. Regulatory Procedures 

Executive Order 12866 requires 

certain regulatory assessments for any 

significant regulatory action that would 

result in an annual effect on the 

economy of $100 million or more, or 

have other substantial impacts. The 

Congressional Review Act establishes 

certain procedures for major rules, 

defined as those with similar major 

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 that would have significant 

impact on a substantial number of small 

entities. This interim final rule will not 

have an impact on the economy greater 

than $100 million annually. Further, it 

will not have a major impact as that 

term is used under the Congressional 

Review Act nor will have a significant 

impact on a substantial number of small 

entities. This rule, however, does 

address novel policy issues relating to 

implementation of a new medical 

benefits program for certain dependents 

of the uniformed services. Thus, this 

rule has been reviewed by the Office of 

Management and Budget under E.O. 

12866. 

Paperwork Reduction Act of 1995 

Section III of this interim final rule 

contains information collection 

requirements. DoD has submitted the 

following proposal to OMB under the 

provisions of the Paperwork Reduction 

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

are invited on: (a) Whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of DoD, including whether the 

information will have practical utility; 

(b) the accuracy of the 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 the use of automated 

collection techniques or other forms of 

information technology. 

Title: TRICARE Young Adult 

Application. 

Type of Request: Revision. 

Number of Respondents: 60,000. 

Responses per Respondent: Estimated 

responses are on average two per 

respondent during the term of their 

TRICARE Young Adult coverage. 

Respondents will complete the 

application upon applying for, 

changing, or terminating their TRICARE 

Young Adult coverage. Not all 

respondents will change their coverage, 

and others may choose to let their 

coverage lapse or stop paying premiums 

instead of submitting a termination 

request. 

Annual Responses: 120,000. 

Average Burden Per Response: The 

public reporting burden for this 

collection of information is estimated to 

average 15 minutes per response, 

including the time for reviewing 

instructions, searching existing data 

sources, gathering and maintaining the 

data needed, and completing and 

reviewing the collection of information. 

Annual Burden Hours: 30,000 hours. 

Needs and Uses: To evaluate 

eligibility of young adult dependents 

applying for extended dependent 

coverage under the TRICARE Young 

Adult program (10 U.S.C. 1110b). 

Affected Public: Young adult 

dependents applying for, changing, or 

terminating their extended medical 

coverage under the TRICARE Young 

Adult program. 

Frequency: Whenever the respondent 

wishes to apply for extended dependent 

coverage under the TRICARE Young 

Adult program, when the respondent 

wishes to change their coverage under 

the TRICARE Young Adult program, or 

when the respondent wishes to 

terminate their coverage under the 

TRICARE Young Adult program. 

Respondent’s Obligation: Required to 

obtain or retain benefits. Young adult 

dependents wishing to purchase 

extended dependent coverage will 

complete the application to apply for, 

change, or terminate medical coverage 

under the TRICARE Young Adult 

program. Respondents will complete the 

requested information. Disclosure is 

voluntary; however, failure to provide 

the information will result in the denial 

of the application. 

OMB Desk Officer 

Written comments and 

recommendations on the proposed 

information collection should be sent to 

Ms. Jasmeet Seehra at the Office of 

Management and Budget, DoD Desk 

Officer, Room 10102, New Executive 

Office Building, Washington, DC 20503, 

with a copy to the TRICARE 

Management Activity, 5111 Leesburg 

Pike, Suite 810A, Falls, Church, VA 

22041. Comments can be received from 

30 to 60 days after the date of this 

notice, but comments to OMB will be 

most useful if received by OMB within 

30 days after the date of this notice. 

You may also submit comments, 

identified by docket 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 

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. 

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, 5111 Leesburg Pike, Suite 

810A, Falls Church, VA 22041, Mark 

Ellis, (703) 681–0039. 

Additional Regulatory Procedures 

We have examined the impact(s) of 

the interim final 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. The preemption 

provisions in the rule conform to law 

and long-established TRICARE policy. 

Therefore, consultation with State and 

local officials is not required. 

This rule is being published as an 

interim final rule with comment period 

as an exception to our standard practice 

of first soliciting public comment under 

a proposed rule, in order to comply with 

the requirements of the Ike Skelton 

National Defense Authorization Act for 

Fiscal Year 2011, Public Law 111–383, 

Section 702, which was enacted on 

January 7, 2011. This section provides 

‘‘the amendments by this section shall 

take effect on January 1, 2011. The 

Secretary of Defense shall prescribe an 

interim final rule with respect to such 

amendments, effective not later than 

January 1, 2011.’’ In order to provide 

coverage as soon as possible consistent 

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Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 23483 

with statutory requirement, and as 

proscribed by the provision, the 

ASD(HA) has determined that following 

the standard practice is unnecessary, 

impractical, and contrary to the public 

interest. Public comments are welcome 

and will be considered before 

publication of the final rule. 

List of Subjects in 32 CFR Part 199 

Claims, Handicapped, Health 

insurance, and Military personnel. 

Accordingly, 32 CFR part 199 is 

amended as follows: 

PART 199—[AMENDED] 

■ 1. The authority citation for part 199 

continues to read as follows: 

Authority: 5 U.S.C. 301; 10 U.S.C. chapter 

55. 

■ 2. Section 199.2(b) is amended by 

adding in alphabetical order the 

definition of ‘‘TRICARE Young Adult’’ to 

read as follows: 

§ 199.2 Definitions. 

* * * * * 

(b) * * * 

TRICARE Young Adult. The program 

authorized by and described in § 199.26 

of this part. 

* * * * * 

■ 3. Section 199.26 is added to read as 

follows: 

§ 199.26 TRICARE Young Adult. 

(a) Establishment. The TRICARE 

Young Adult (TYA) program offers the 

medical benefits provided under the 

TRICARE programs to qualified 

unmarried adult children who do not 

otherwise have eligibility for medical 

coverage under a TRICARE program at 

age 21 (23 if enrolled in a full-time 

course of study at an institution of 

higher learning approved by the 

Secretary of Defense) and are under age 

26. 

(1) Purpose. As specified in paragraph 

(c) of this section, TRICARE Young 

Adult is a premium-based health plan 

that is available for purchase by any 

qualified adult child as that term is 

defined in paragraph (b) of this section. 

The TRICARE Young Adult program 

allows a qualified adult child to 

purchase TRICARE coverage. 

(2) Statutory authority. TRICARE 

Young Adult is authorized by 10 U.S.C. 

1110b. 

(3) Scope of the program. TRICARE 

Young Adult is geographically 

applicable to the same extent as 

specified in section 199.1(b)(1) of this 

part. 

(4) Major features of TRICARE Young 

Adult. (i) TRICARE rules applicable. 

(A) Unless specified in this section or 

otherwise prescribed by the ASD (HA), 

provisions of this Part apply to 

TRICARE Young Adult. 

(B) The TRICARE Dental Program 

(§ 199.13 of this part) and the TRICARE 

Retiree Dental Program (§ 199.22 of this 

part) are not covered under TRICARE 

Young Adult. 

(C) TRICARE Standard is available to 

all TYA-eligible young adult 

dependents. TYA enrollees in TRICARE 

Standard may use TRICARE Extra 

(under § 199.17(e) of this Part). 

(D) TRICARE Prime is available to 

TYA-eligible young adult dependents of 

sponsors to the same extent it is 

available to those sponsors’ dependents 

who do not exceed the age requirements 

of § 199.3 of this part, provided that 

TRICARE Prime is available in the 

geographic location where the TYA 

enrollee resides. This applies to TYAeligible: 

(1) Dependents of sponsors on active 

duty for more than 30 days or covered 

by TAMP (under § 199.3(e)); 

(2) Dependents of sponsors who are 

retired members eligible for TRICARE 

Prime; and 

(3) Survivors of members who died 

while on active duty for more than 30 

days or while receiving retired or 

retainer pay. 

(ii) Premiums. TRICARE Young Adult 

coverage is a premium based program 

that an eligible young adult dependent 

may purchase. There is only individual 

coverage, and a premium shall be 

charged for each dependent even if 

there is more than one qualified 

dependent in the military sponsor’s 

family that qualifies for TRICARE 

Young Adult coverage. Dependents 

qualifying for TRICARE Young Adult 

status can purchase individual 

TRICARE Standard or Prime coverage 

(as applicable) according to the rules 

governing the TRICARE program for 

which they are qualified on the basis of 

their military sponsor’s status (active 

duty, retired, Selected Reserve, or 

Retired Reserve) and the availability of 

a desired plan in their geographic 

location. Premiums shall be determined 

in accordance with paragraph (c) of this 

section. 

(iii) Procedures. Under TRICARE 

Young Adult, qualified dependents 

under paragraph (b) of this section may 

purchase individual TRICARE coverage 

by submitting a completed request in 

the appropriate format along with an 

initial payment of the applicable 

premium. Procedures for purchasing 

coverage and paying applicable 

premiums are prescribed in paragraph 

(d) of this section. 

(iv) Benefits. When their TRICARE 

coverage becomes effective, qualified 

beneficiaries receive the benefit of the 

TRICARE program that they selected, 

including, if applicable, access to 

military treatment facilities and 

pharmacies. TRICARE Young Adult 

coverage features the per service cost 

share, deductible and catastrophic cap 

provisions based on program selected, 

i.e., the TRICARE Standard/Extra 

program or the TRICARE Prime 

program, as well as the status of their 

military sponsor. Access to military 

treatment facilities under the system of 

access priorities in section 199.17(d)(1) 

of this Part is also based on the program 

selected as well as the status of the 

military sponsor. Premiums are not 

credited to deductibles or catastrophic 

caps. 

(v) Transition period. During fiscal 

year 2011, the TYA program will 

include only TRICARE Standard 

program coverage. 

(b) Eligibility for TRICARE Young 

Adult coverage.—(1) Young adult 

dependent. A young adult dependent 

qualifies to purchase TRICARE Young 

Adult coverage if the dependent meets 

the following criteria: 

(i) Would be a dependent child under 

section 199.3 of this Part but for 

exceeding the age limit under that 

section; and 

(ii) Is a dependent under the age of 26; 

and 

(iii) Is not enrolled, or eligible to 

enroll, for medical coverage in an 

eligible employer-sponsored health plan 

as defined in section 5000A(f)(2) of the 

Internal Revenue Code of 1986; and 

(iv) Is not otherwise eligible under 

section 199.3 of this Part; and 

(v) Is not a member of the uniformed 

services. 

(2) The dependents’ sponsor is 

responsible for keeping the Defense 

Enrollment Eligibility Reporting System 

(DEERS) current with eligibility data 

through the sponsor’s Service personnel 

office. Using information from the 

DEERS, the managed care support 

contractors have the responsibility to 

validate a dependent’s qualifications to 

purchase TRICARE Young Adult 

coverage. 

(c) TRICARE Young Adult premiums. 

Qualified young adult dependents are 

charged premiums for coverage under 

TRICARE Young Adult that represent 

the full cost of the program, including 

reasonable administrative costs, as 

determined by the ASD(HA) utilizing an 

appropriate actuarial basis for the 

provision of TRICARE benefits for the 

TYA-eligible beneficiary population. 

Separate premiums shall be established 

for TRICARE Standard and Prime plans. 

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23484 Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 

There may also be separate premiums 

based on the uniformed services 

sponsor’s status. Premiums are to be 

paid monthly. The monthly rate for each 

month of a calendar year is one-twelfth 

of the annual rate for that calendar year. 

(1) Annual establishment of rates. 

—(i) TRICARE Young Adult monthly 

premium rates shall be established and 

updated annually on a calendar year 

basis by the ASD(HA) for TRICARE 

Young Adult individual coverage. 

(ii) The appropriate actuarial basis 

used for calculating premium rates shall 

be one that most closely approximates 

the actual cost of providing care to a 

similar demographic population (based 

on age and health plans) as those 

enrolled in TRICARE Young Adult, as 

determined by the ASD(HA). TRICARE 

Young Adult premiums shall be based 

on the actual costs of providing benefits 

to TYA dependents during the 

preceding years if the population of 

TYA enrollees is large enough during 

those preceding years to be considered 

actuarially appropriate. Until such time 

that actual costs from those preceding 

years become available, TRICARE 

Young Adult premiums shall be based 

on the actual costs during the preceding 

calendar years for providing benefits to 

the population of similarly aged 

dependents to make the underlying 

group actuarially appropriate. An 

adjustment may be applied to cover 

overhead costs for administration of the 

program. 

(2) Premium adjustments. In addition 

to the determinations described in 

paragraph (c)(1) of this section, 

premium adjustments may be made 

prospectively for any calendar year to 

reflect any significant program changes 

mandated by legislative enactment, 

including but not limited to significant 

new programs or benefits. 

(d) Procedures. The Director, 

TRICARE Management Activity (TMA), 

may establish procedures for the 

following. 

(1) Purchasing coverage. Procedures 

may be established for a qualified 

dependent to purchase individual 

coverage. To purchase TRICARE Young 

Adult coverage for effective dates of 

coverage described below, qualified 

dependents must submit a request in the 

appropriate format, along with an initial 

payment of the applicable premium 

required by paragraph (c) of this section 

in accordance with established 

procedures. 

(i) Continuation coverage. Procedures 

may be established by the Director, 

TRICARE Management Activity for a 

qualified dependent to purchase 

TRICARE Young Adult coverage with an 

effective date immediately following the 

date of termination of coverage under 

another TRICARE program. Application 

for continuation coverage must be made 

within 30 days of the date of 

termination of coverage under another 

TRICARE program. 

(ii) Open enrollment. Procedures may 

be established for a qualified dependent 

to purchase TRICARE Young Adult 

coverage at any time. The effective date 

of coverage will coincide with the first 

day of a month. 

(iii) Retroactive coverage. A qualified 

young adult dependent may elect 

retroactive TRICARE Standard coverage 

effective as of January 1, 2011 if 

dependent was eligible as of that date. 

In the case of a young adult dependent 

who was not eligible as of January 1, 

2011, but became eligible after that date 

but prior to the date of enrollment, the 

young adult dependent may elect 

retroactive TRICARE Standard coverage 

effective as of the date of eligibility. If 

retroactive coverage is elected, 

retroactive premiums must be paid for 

the time period between initial 

eligibility and the date of the election. 

If no retroactive coverage is elected or 

the retroactive premiums are not paid 

within the time prescribed, coverage 

will not be retroactive and coverage will 

apply only prospectively under the 

procedures set forth for open 

enrollment. No purchase of retroactive 

coverage may take place after September 

30, 2011. Coverage under TRICARE 

Prime may not be made retroactively. 

(2) Termination of coverage. (i) Loss 

of eligibility or entitlement for coverage 

by the sponsor will result in termination 

of the dependent’s TRICARE Young 

Adult coverage unless otherwise 

specified. The effective date of the 

sponsor’s loss of eligibility for care will 

also be the effective date of termination 

of benefits under the TYA program 

unless specified otherwise. 

(A) Active Duty Military Sponsor. 

TYA coverage ends effective the date of 

military sponsor’s separation from 

military service. Upon the death of an 

active duty sponsor, dependents eligible 

for Transitional Survivor coverage may 

purchase TYA coverage up to the age of 

26. 

(B) Selected Reserve (Sel Res) 

Sponsor. Sel Res sponsors must be 

currently enrolled in TRICARE Reserve 

Select (TRS) before a young adult 

dependent is eligible to purchase TYA. 

If TRS coverage is terminated by the 

sponsor, TYA coverage ends effective 

the same termination date as the 

sponsor. If the Sel Res sponsor dies 

while enrolled in TRS, the young adult 

dependent is eligible to purchase TYA 

coverage for six months after the date of 

death of the Sel Res sponsor, if 

otherwise eligible. 

(C) Retired Reserve Sponsor. Retired 

Reserve members not yet eligible for 

retired or retainer pay must be enrolled 

in TRICARE Retired Reserve (TRR) to 

establish TYA eligibility for their young 

adult dependents. If TRR coverage is 

terminated by the sponsor, the TYA 

coverage for the young adult dependent 

ends effective the same date as the 

sponsor’s termination of coverage under 

TRR. If the retired reserve sponsor dies 

while enrolled in TRR, the young adult 

dependent may continue to purchase 

TYA coverage until the date on which 

the deceased member would have 

attained age 60, as long as otherwise 

eligible. If the Retired Reserve member 

dies and is not enrolled in TRR, there 

is no eligibility for TYA coverage until 

the sponsor would have reached age 60. 

On the date the military sponsor would 

have reached 60, a young adult 

dependent who otherwise qualifies for 

TYA qualifies as a dependent of a 

deceased retired sponsor and can 

purchase TYA coverage. 

(ii) Failure of a young adult 

dependent to maintain the eligibility 

qualifications in paragraph (b) of this 

section shall result in the termination of 

coverage under the TYA program. The 

effective date of termination shall be the 

date upon which the adult young 

dependent failed to meet any of the 

perquisite qualifications. If a subsequent 

change in circumstances re-establishes 

eligibility (such as losing eligibility for 

an eligible employer-sponsored plan), 

the young adult dependent may reenroll for coverage under the TYA 

program. 

(iii) Termination of coverage results in 

denial of claims for services with a date 

of service after the effective date of 

termination. 

(iv) Covered dependents may request 

termination of coverage at any time by 

submitting a completed request in the 

appropriate format in accordance with 

established procedures. 

(3) Lockout. Dependents whose 

coverage under TRICARE Young Adult 

terminates for failure to pay premiums 

will not be allowed to purchase 

coverage again under TYA for a period 

of one year following the effective date 

of termination. Dependents who are 

terminated for failure to pay may 

request a waiver of the lockout from the 

Director, TRICARE Management 

Activity if extraordinary circumstances, 

as determined by the Director, 

prevented the dependent from being 

able to pay the premium. The Director 

may also provide a grace period not to 

exceed 90 days after the end of the 

month during which the last full 

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Federal Register / Vol. 76, No. 81 / Wednesday, April 27, 2011 / Rules and Regulations 23485 

premium was paid, during which a 

young adult dependent who would 

otherwise be subject to a lockout may be 

reinstated by the payment of all unpaid 

premiums. After 90 days, any waiver of 

a lockout by the Director shall allow the 

young adult dependent to re-enroll but 

not to receive retroactive coverage. 

(4) Eligibility for the Continued Health 

Care Benefit Program. Upon termination 

of eligibility to purchase TYA coverage, 

dependents may purchase coverage for 

up to 36 months through the Continued 

Health Care Benefit Program under 

section 199.20 of this Part unless locked 

out of TYA. 

(5) Changing Coverage. Upon 

application and payment of appropriate 

premiums, qualified dependents already 

enrolled in and who are current in their 

premium payments may elect to change 

to another TRICARE program for which 

the qualified dependent is eligible based 

on the sponsor’s eligibility and the 

geographic location of the qualified 

young adult dependent. The Director, 

TMA shall establish administrative 

processes for this change in program 

enrollment; however, no change shall be 

effective until the applicable premium 

has been paid. 

(e) Preemption of State Laws.—The 

preemption provisions of § 199.17(a)(7) 

of this part are applicable to the TYA 

program. 

(f) Administration. The Director, 

TRICARE Management Activity, may 

establish other processes, policies and 

procedures for the effective 

administration of TRICARE Young 

Adult and may authorize exceptions to 

requirements of this section, if 

permitted by law, based on 

extraordinary circumstances. 

Dated: April 22, 2011. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2011–10241 Filed 4–25–11; 11:15 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Coast Guard 

33 CFR Part 165 

[Docket No. USCG–2011–0260] 

RIN 1625–AA00 

Safety Zone; Red River 

AGENCY: Coast Guard, DHS. 

ACTION: Temporary final rule. 

SUMMARY: The Coast Guard is 

establishing a temporary safety zone for 

all waters of the Red River in the State 

of North Dakota, including those 

portions of the river bordered by 

Richland, Cass, Traill, Grand Forks, 

Walsh, and Pembina Counties, plus 

those in Minnesota South of a line 

drawn across latitude 46°20′00′′ N, 

extending the entire width of the river. 

This safety zone is needed to protect 

persons and vessels from safety hazards 

associated with flooding occurring on 

the Red River. Entry into this zone is 

prohibited unless specifically 

authorized by the Captain of the Port 

Sector Upper Mississippi River or a 

designated representative. 

DATES: This rule is effective in the CFR 

from April 27, 2011 through 11:59 p.m. 

on July 15, 2011. This rule is effective 

with actual notice from 12:01 a.m. on 

April 8, 2011, until 11:59 p.m. on July 

15, 2011. 

ADDRESSES: Documents indicated in this 

preamble as being available in the 

docket are part of docket USCG–2011– 

0260 and are available online by going 

to http://www.regulations.gov, inserting 

USCG–2011–0260 in the ‘‘Keyword’’ 

box, and then clicking ‘‘Search.’’ They 

are also available for inspection or 

copying at the Docket Management 

Facility (M–30), U.S. Department of 

Transportation, West Building Ground 

Floor, Room W12–140, 1200 New Jersey 

Avenue, SE., Washington, DC 20590, 

between 9 a.m. and 5 p.m., Monday 

through Friday, except Federal holidays. 

Documents will also be available for 

inspection or copying at Coast Guard 

Sector Upper Mississippi River, 1222 

Spruce Street, Suite 7.103, St. Louis, 

MO 63103 between 7:30 a.m. and 

4 p.m., Monday through Friday, except 

Federal holidays. 

FOR FURTHER INFORMATION CONTACT: If 

you have questions on this temporary 

rule, call or email Lieutenant 

Commander (LCDR) Scott Stoermer, 

Sector Upper Mississippi River, Coast 

Guard at (314) 269–2540 or 

Scott.A.Stoermer@uscg.mil. 

SUPPLEMENTARY INFORMATION: 

Regulatory Information 

The Coast Guard is issuing this 

temporary final rule without prior 

notice and opportunity to comment 

pursuant to authority under section 4(a) 

of the Administrative Procedure Act 

(APA) (5 U.S.C. 553(b)). This provision 

authorizes an agency to issue a rule 

without prior notice and opportunity to 

comment when the agency for good 

cause finds that those procedures are 

‘‘impracticable, unnecessary, or contrary 

to the public interest.’’ Under 5 U.S.C. 

553(b)(B), the Coast Guard finds that 

good cause exists for not publishing a 

notice of proposed rulemaking (NPRM) 

with respect to this rule because it 

would be contrary to public interest to 

publish an NPRM as immediate action 

is necessary to protect the public and 

property from the dangers associated 

with flooding emergencies. Under 5 

U.S.C. 553(d)(3), the Coast Guard finds 

that good cause exists for making this 

rule effective less than 30 days after 

publication in the Federal Register. 

Delaying its effective date would be 

contrary to public interest because 

immediate action is needed to protect 

vessels and mariners from the safety 

hazards associated with flooding 

emergencies. 

Basis and Purpose 

On April 8, 2011, the Captain of the 

Port Upper Mississippi River deemed 

navigation on the Red River unsafe due 

to severe flooding and has closed 

navigation on the Red River bordered by 

Richland, Cass, Traill, Grand Forks, 

Walsh, and Pembina Counties in North 

Dakota, extending the entire width of 

the river. To provide for the safety of the 

public, the Coast Guard will temporarily 

restrict access to this section of the Red 

River while conditions remain 

dangerous. 

Discussion of Rule 

The Coast Guard is establishing a 

temporary safety zone for all waters of 

the Red River in the State of North 

Dakota, including those portions of the 

river bordered by Richland, Cass, Traill, 

Grand Forks, Walsh, and Pembina 

Counties, plus those in Minnesota South 

of a line drawn across latitude 46°20′00′′ 

N, extending the entire width of the 

river. Entry into this zone is prohibited 

to all vessels and persons except those 

persons and vessels specifically 

authorized by the Captain of the Port 

Sector Upper Mississippi River. This 

rule is effective from 12:01 a.m. April 8, 

2011 until 11:59 p.m. July 15, 2011. 

This temporary safety zone will be 

enforced while conditions remain 

dangerous. The Captain of the Port 

Sector Upper Mississippi River will 

inform the public through broadcast 

notice to mariners of all safety zone 

changes and enforcement periods. 

Regulatory Evaluation 

This rule is not a ‘‘significant 

regulatory action’’ under section 3(f) of 

Executive Order 12866, Regulatory 

Planning and Review, and does not 

require an assessment of potential costs 

and benefits under section 6(a)(3) of that 

Order. The Office of Management and 

Budget has not reviewed it under that 

Order. It is not ‘‘significant’’ under the 

regulatory policies and procedures of 

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