Federal Register / Vol. 76, No. 180 / Friday, September 16, 2011 / Rules and Regulations 57637 

agency must issue a rule justifying the 

exemption. 

The new systems of records may 

include investigatory materials 

compiled in connection with the 

Commission’s enforcement of the 

federal securities laws, in connection 

with potential or actual incidents of 

workplace violence, or in connections 

with complaints, inquiries or requests 

from the public. The Commission and 

investors will benefit from the 

amendments, because in their absence 

the potential access to or disclosure of 

the investigatory materials in these 

systems of records could seriously 

undermine the effective enforcement of 

the Federal securities laws, and could 

jeopardize the safety and security of 

Commission employees in the 

workplace. 

We recognize that the proposed 

amendments may impose costs on 

individuals who may wish to obtain 

access to records that contain 

investigatory materials in these systems 

of records. We have no way of 

estimating the potential number of 

individuals who might in the future 

desire such access. Nevertheless, the 

benefits of exempting those records 

from public access are compelling, and 

they clearly justify the costs of the 

exemption. In addition, Congress was 

aware of such potential costs when they 

promulgated the specific exemption in 5 

U.S.C. 552a(k)(2). The Commission 

discussed these costs and benefits in the 

proposing release and received no 

comments on them. 

Regulatory Flexibility Act Certification 

Pursuant to the requirements of the 

Regulatory Flexibility Act, 5 U.S.C. 601– 

612, SEC certified that these regulations 

would not significantly affect a 

substantial number of small entities. 

The rule imposes no duties or 

obligations on small entities. Further, in 

accordance with the provisions of the 

Paperwork Reduction Act of 1995, 44 

U.S.C. 3501, SEC has determined that 

this rule would not impose new 

recordkeeping, application, reporting, or 

other types of information collection 

requirements. The Commission 

provided this certification in the 

proposing release and received no 

comments. 

List of Subjects in 17 CFR Part 200 

Administrative practice and 

procedure; Privacy. 

Text of Amendments 

For the reasons set out in the 

preamble, Title 17, Chapter II, of the 

Code of Federal Regulations is amended 

as follows: 

PART 200—ORGANIZATION; 

CONDUCT AND ETHICS; AND 

INFORMATION AND REQUESTS 

■ 1. The authority citation for Part 200 

is amended by adding authority for 

§ 200.312 in numerical order to read as 

follows: 

Authority: 15 U.S.C. 77o, 77s, 77sss, 78d, 

78d–1, 78d–2, 78w, 78ll(d), 78mm, 80a–37, 

80b–11, and 7202, unless otherwise noted. 

* * * * * 

Section 200.312 is also issued under 5 

U.S.C. 552a(k). 

* * * * * 

Subpart H—Regulations Pertaining to 

the Privacy of Individuals and Systems 

of Records Maintained by the 

Commission 

■ 2. Amend § 200.312 by: 

■ a. Removing ‘‘and’’ at the end of 

paragraph (a)(5); 

■ b. Removing the period at the end of 

paragraph (a)(6) and adding a semicolon 

in its place; 

■ c. Adding paragraphs (a)(7), (a)(8) and 

(a)(9); 

■ d. Revising paragraph (b); and 

■ e. Removing the authority citation at 

the end of the section. 

The additions and revision read as 

follows. 

§ 200.312 Specific exemptions. 

* * * * * 

(a) * * * 

(7) Tips, Complaints, and Referrals 

(TCR) Records; 

(8) SEC Security in the Workplace 

Incident Records; and 

(9) Investor Response Information 

System (IRIS). 

(b) Pursuant to 5 U.S.C. 552a(k)(5), the 

system of records containing the 

Commission’s Disciplinary and Adverse 

Actions, Employee Conduct, and Labor 

Relations Files shall be exempt from 

sections (c)(3), (d), (e)(1), (e)(4)(G), (H), 

and (I), and (f) of the Privacy Act, 5 

U.S.C. 552a(c)(3), (d), (e)(1), (e)(4)(G), 

(e)(4)(H), and (e)(4)(I), and (f), and 17 

CFR 200.303, 200.304, and 200.306 

insofar as they contain investigatory 

material compiled to determine an 

individual’s suitability, eligibility, and 

qualifications for Federal civilian 

employment or access to classified 

information, but only to the extent that 

the disclosure of such material would 

reveal the identity of a source who 

furnished information to the 

Government under an express promise 

that the identity of the source would be 

held in confidence, or, prior to 

September 27, 1975, under an implied 

promise that the identity of the source 

would be held in confidence. 

By the Commission. 

Dated: September 12, 2011. 

Elizabeth M. Murphy, 

Secretary. 

[FR Doc. 2011–23732 Filed 9–15–11; 8:45 am] 

BILLING CODE 8011–01–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[DOD–2009–HA–0068] 

RIN 0720–AB30 

TRICARE; Continued Health Care 

Benefit Program Expansion 

AGENCY: Office of the Secretary, 

Department of Defense. 

ACTION: Final rule. 

SUMMARY: This final rule executes the 

expansion of section 1078a of title 10, 

United States Code (U.S.C). With the 

recent expansions of Military Health 

System (MHS) coverage, particularly 

with the Reserve Component (RC) 

members, some MHS beneficiaries 

would not be eligible to purchase 

Continued Health Care Benefit Program 

(CHCBP) coverage under certain 

circumstances that terminate their MHS 

coverage. This provision allows the 

Secretary to establish CHCBP eligibility 

for any category of MHS beneficiaries 

who otherwise would lose MHS 

coverage with no continued care 

eligibility. Although the proposed rule 

listed each authorized category of MHS 

beneficiary eligible to receive care, on 

further examination this format for the 

rule appeared cumbersome and perhaps 

confusing. Thus this final rule contains 

some organizational changes to simplify 

the rule to enhance understanding and 

make clear that any category including 

future categories of beneficiaries are 

entitled to purchase this CHCBP 

coverage. This final rule also includes 

administrative changes providing 

clarification on eligibility notifications 

and the CHCBP premium rate 

publication process. It updates the 

previous final rule published in the 

Federal Register on September 30, 1994. 

DATES: Effective Date: October 17, 2011. 

FOR FURTHER INFORMATION CONTACT: Mr. 

Mark Ellis, TRICARE Policy and 

Operations, TRICARE Management 

Activity, 5111 Leesburg Pike, Suite 810, 

Falls Church, VA 22041, telephone 

(703) 681–0039. 

SUPPLEMENTARY INFORMATION: 


erowe on DSK2VPTVN1PROD with RULES
57638 Federal Register / Vol. 76, No. 180 / Friday, September 16, 2011 / Rules and Regulations 

I. Introduction and Background 

CHCBP is the program that provides 

continued health care coverage for 

eligible beneficiaries who lose their 

MHS eligibility. It was initially 

established by Congress in section 4408 

of the National Defense Authorization 

Act (NDAA) for Fiscal Year (FY) 1993, 

Public Law 102–484, which amended 

title 10 U.S.C., by adding section 1078a. 

The Department of Defense (DoD) 

published the initial final rule regarding 

CHCBP in the Federal Register on 

September 30, 1994, (59 FR 49817). It is 

modeled after private sector insurance 

programs giving some employees the 

ability to continue health insurance 

coverage after leaving employment as 

authorized by the Consolidated 

Omnibus Budget Reconciliation Act 

(COBRA) of 1985. ‘‘COBRA Coverage’’ 

requires the individual to pay up to 

100 percent of the program cost plus an 

amount to cover administrative 

expenses. 

Section 713 of the NDAA for FY 2004 

expanded the category of persons 

authorized coverage to include the 

uniformed services that are not armed 

forces. A final rule implementing this 

change was published in the Federal 

Register on September 30, 1994. The 

statute was again amended by Section 

705 of the NDAA for FY 2008 which 

authorized the expansion of persons 

eligible for the CHCBP under 10 U.S.C. 

1078a to include any person specified 

by regulation prescribed by the 

Secretary who was authorized coverage 

under 10 U.S.C. chapter 55 and who 

loses that eligibility. The proposed rule 

to implement this change was published 

in the Federal Register on November 27, 

2009. The intent of the proposed rule 

and this final rule is to specify that any 

person who is currently authorized 

coverage under 10 U.S.C. chapter 55 or 

10 U.S.C. 1145(a) and any person who 

may in the future be authorized 

coverage under chapter 55 of 10 U.S.C. 

or 10 U.S.C. 1145(a) and who loses that 

eligibility shall be authorized coverage 

under the CHCBP. 

Currently, CHCBP provides coverage 

for certain active duty (AD) service 

members and their family members as 

well as RC members and their families. 

The coverage period is up to 36 months 

after the date on which the person first 

ceases to be covered under his or her 

respective program eligibility. However, 

for RC members the coverage is for 

18 months from either separation from 

AD or when coverage under the 

Transitional Assistance Management 

Program (TAMP) (10 U.S.C. 1145(a)) 

ends. 

The 2008 change to 10 U.S.C. 1078a 

expands CHCBP to all who the Secretary 

specifies in regulation who lose 

entitlement or eligibility to health care 

services under 10 U.S.C. chapter 55 

Therefore, members or former members 

of the RC, such as TRICARE Reserve 

Select under 10 U.S.C. 1076d or 

TRICARE Retired Reserve under 10 

U.S.C. Section 1076e coverage under 

CHCBP will now run for 18 months after 

the date the member ceases to be 

eligible for benefits under their 

respective Reserve program’s eligibility. 

The rule also standardizes the number 

of days that a written election by an 

eligible beneficiary must be made to 

sixty (60) days after loss of entitlement 

or eligibility. Previously, those losing 

eligibility for TRICARE Reserve Select 

had only thirty (30) days to elect CHCBP 

coverage. The rule clarifies that 

individual locked out of other TRICARE 

plans per the other TRICARE program 

rules are not eligible to purchase 

CHCBP. 

II. Public Comments 

The proposed rule was published in 

the Federal Register on November 27, 

2009 (74 FR 62271), for a 60-day 

comment period. We received 

comments from one individual. We 

thank the commenter for his comments. 

Specific matters raised are summarized 

below. 

Comment: One commenter said the 

final changes to the CHCBP could be 

extremely beneficial to current and 

former service members, but that 

eligibility for health care for National 

Guard/RC members after the member 

ceases to be entitled to care under 10 

U.S.C. 1074(a) (AD) or 10 U.S.C. 1145(a) 

(TAMP) should be extended to at least 

24 months to maximize the opportunity 

for care. The commenter noted many 

health issues that service members are 

experiencing in theater need more time 

to be fully understood by the member 

and to be officially diagnosed. By 

extending an additional six months, 

service members who may be in denial 

about health issues or who may be 

having trouble transitioning to ‘‘civilian’’ 

life would have more time to obtain 

medical and dental care. 

Response: The period of CHCBP 

eligibility after a period of AD or TAMP 

is limited by statute to 18 months. 

However, the 6 months of TAMP plus 

the 18 months of CHCBP allows the 

member the opportunity for 24 months 

of care. 

Comment: One comment asked for 

clarity as to how long a ‘‘specific and 

limited period of time’’ CHCBP can 

continue. 

Response: Eligibility timeframes for 

CHCBP vary by beneficiary category and 

are outlined in 32 CFR 199.20(d)(1). 

Comment: One comment asked who 

would be considered a ‘‘certain former 

spouse’’ who is eligible for CHCBP. 

Response: Eligibility for unremarried 

former spouses is outlined in 32 CFR 

199.20(d)(1)(iii). 

III. Provisions of Final Rule 

This rule expands eligibility to 

purchase CHCBP coverage for any 

beneficiary that loses entitlement or 

eligibility for medical care under 10 

U.S.C. chapter 55 or 10 U.S.C. 1145(a), 

subject to the coverage limits of 10 

U.S.C. 1078a. 

The final rule incorporates a number 

of revisions from the proposed rule to 

clarify the expanded coverage adopted 

by Congress in section 705 of the NDAA 

for FY 2008 to ensure that all future 

beneficiaries under 10 U.S.C. chapter 55 

or 10 U.S.C. 1145 who lose eligibility for 

care under those parts will be eligible to 

purchase CHCBP. For example in 

relation to coverage of RC personnel and 

their family members, the children of 

RC personnel who are covered 

dependent children under TRS and who 

reach the coverage age limit will have 

the same CHCBP eligibility as their 

counterparts who are children of AD 

personnel. As another example, a 

surviving spouse and child of a RC 

member who dies and who were 

covered by TRR will have the 

opportunity to obtain CHCBP coverage 

for up to three years after TRR coverage 

ends. 

Administrative Changes 

This final rule provides for improved 

administration of CHCBP by: Allowing 

the Department of Defense and the other 

uniformed services the ability to 

delegate to a designee the responsibility 

for notifying persons eligible to receive 

health benefits under the CHCBP; 

requiring supporting documentation on 

any change in status that would make a 

child eligible for CHCBP; allowing 

notification of a former spouse’s 

potential eligibility for CHCBP to be 

made to the CHCBP contractor by the 

member, former member, or former 

spouse; establishing a 14-day period 

within which the CHCBP contractor 

must advise former spouses of their 

potential eligibility for CHCBP; and 

discontinuing the requirement that 

CHCBP premium rates be published 

annually but, instead, requiring that the 

premium rates be published whenever a 

change in rate occurs. There have been 

no changes in this final rule from the 

proposed rule on these administrative 

matters. 


erowe on DSK2VPTVN1PROD with RULES
Federal Register / Vol. 76, No. 180 / Friday, September 16, 2011 / Rules and Regulations 57639 

This final rule also makes minor 

editorial changes in an attempt to 

improve understanding of CHCBP 

program requirements and processes, 

including making grammatical 

improvements in the text of § 199.20. 

There have been a few minor changes in 

this final rule from the proposed rule on 

these editorial matters. These include 

reference to the ‘‘TRICARE Standard 

program’’ vice the TRICARE basic 

program; reference to the ‘‘CHCBP 

contractor’’ vice the ‘‘Third Party 

Administrator;’’ and reference to 

members of the ‘‘uniformed services’’ 

where the term ‘‘armed forces’’ was 

inadvertently used. Finally, the final 

rule includes a conforming change to 

§ 199.24, deleting the paragraph that 

addressed the relationship between TRS 

and the CHCBP. That relationship is not 

covered by the revised provisions in 

§ 199.20, which governs the CHCBP. 

This final rule also contains 

administrative changes to update 

information regarding the current 

CHCBP and TRICARE programs as 

follows: Updates the ‘‘CHAMPUS’’ 

(Civilian Health and Medical Program of 

the Uniformed Services) program name 

to ‘‘TRICARE’’ when appropriate; 

updates the Department of Defense 

agency name from ‘‘OCHAMPUS’’ (the 

Office of CHAMPUS) to ‘‘TRICARE 

Management Activity’’ (TMA); replaces 

the reference ‘‘Third Party 

Administrator’’ with ‘‘CHCBP 

contractor’’ to make it consistent with 

the ‘‘contractor’’ term used for TMA 

programs; updates ‘‘military health 

services system’’ with ‘‘Military Health 

System;’’ and updates information 

regarding the enrollment process both to 

require the use of the enrollment 

applications or DD Form as designated 

by the Director, TRICARE as well as the 

documentation required to verify an 

applicant’s eligibility for enrollment. 

This final rule contains administrative 

changes to other paragraphs of Title 32 

Code of Federal Regulations, 

specifically in § 199.20, by: Changing 

the title of paragraph (n) of this section 

‘‘Peer Review Organization Program’’ to 

‘‘Quality and Utilization Review Peer 

Review Organization Program;’’ 

changing the title of the program in 

paragraph (p)(2)(ii) from ‘‘Active Duty 

Dependents Dental Plan’’ to ‘‘TRICARE 

Dental Program;’’ and by adding to that 

same paragraph the ‘‘TRICARE Retiree 

Dental Program’’ under § 199.22 as a 

special program that is not available to 

participants in the CHCBP. In addition, 

this final rule deletes paragraph (p)(3) in 

its entirety, as that subpart referenced 

two demonstration projects that are no 

longer in existence and therefore no 

longer available to CHCBP participants: 

The ‘‘Home Health Care Demonstration’’ 

and the ‘‘Home Health Care—Case 

Management Demonstration.’’ There 

have been no changes in this final rule 

from the proposed rule on these 

references. 

IV. Regulatory Procedures 

Executive Order 12866, ‘‘Regulatory 

Planning and Review’’ and Public Law 

96–354, ‘‘Regulatory Flexibility Act’’ 

(5 U.S.C. 601) 

Executive Order 12866 requires that a 

comprehensive regulatory impact 

analysis be performed on any 

economically significant regulatory 

action, defined as one that would result 

in an annual effect of $100 million or 

more on the national economy or which 

would have other substantial 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 which would have a 

significant impact on a substantial 

number of small entities. This rule is 

not an economically significant 

regulatory action and will not have a 

significant impact on a substantial 

number of small entities for purposes of 

the RFA, thus this final rule is not 

subject to any of these requirements. 

Sec. 202, Public Law 104–4, ‘‘Unfunded 

Mandates Reform Act’’ 

This rule does not contain unfunded 

mandates. It does not contain a Federal 

mandate that may result in the 

expenditure by State, local, and tribal 

governments, in aggregate, or by the 

private sector, of $100 million or more 

in any one year. 

Paperwork Reduction Act of 1995 

(44 U.S.C. 3501–3511) 

This rule will not impose additional 

information collection requirements on 

the public. OMB previously cleared the 

collection requirements under OMB 

Control Number 0704–0364. 

Executive Order 13132, ‘‘Federalism’’ 

We have examined the impact(s) of 

the 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, therefore, 

consultation with State and local 

officials is not required. 

List of Subjects in 32 CFR Part 199 

Claims, Dental health, Health care, 

Health insurance, Individuals with 

disabilities, 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 199.20 is revised to read as 

follows: 

§ 199.20 Continued Health Care Benefit 

Program (CHCBP). 

(a) Purpose. The CHCBP is a 

premium-based temporary health care 

coverage program that will be available 

to beneficiaries who meet the eligibility 

and enrollment criteria as set forth in 

paragraph (d)(1) of this section. The 

CHCBP is not part of the TRICARE 

program. However, as set forth in this 

section, it functions under similar rules 

and procedures of the TRICARE 

Standard program. Because the purpose 

of the CHCBP is to provide a 

continuation health care benefit for the 

Department of Defense and the other 

uniformed services (National Oceanic 

and Atmospheric Administration 

(NOAA), Public Health Service (PHS), 

and Coast Guard) beneficiaries losing 

eligibility, it will be administered so 

that it appears, to the maximum extent 

possible, to be part of the TRICARE 

Standard program. Medical coverage 

under this program will be the same as 

the benefits payable under the TRICARE 

Standard program. However, unlike the 

Standard program there is a cost for 

enrollment to the CHCBP and these 

premium costs are payable by enrollees 

before any care may be provided. 

(b) General provisions. Except for any 

provisions the Director of the TRICARE 

Management Activity may exclude, the 

general provisions of § 199.1 shall apply 

to the CHCBP as they do to TRICARE. 

(c) Definitions. Except as may be 

specifically provided in this section, to 

the extent terms defined in § 199.2 are 

relevant to the administration of the 

CHCBP, the definitions contained in 

that section shall apply to the CHCBP as 

they do to the TRICARE Standard 

program. 

(d) Eligibility and enrollment. (1) 

Eligibility, Enrollment in the CHCBP is 

open to any individual, except as noted 

in this section, who: 

(i) Ceases to meet the requirements for 

eligibility under 10 U.S.C. chapter 55 or 

10 U.S.C. 1145, and 

(ii) Who on the day before they cease 

to meet the eligibility requirements for 


erowe on DSK2VPTVN1PROD with RULES
57640 Federal Register / Vol. 76, No. 180 / Friday, September 16, 2011 / Rules and Regulations 

such care they were covered under a 

health benefit plan under 10 U.S.C. 

chapter 55 or transitional healthcare 

under 10 U.S.C. 1145, and 

(iii) Who would otherwise not be 

eligible for any benefits under 10 U.S.C. 

chapter 55 or 10 U.S.C. 1145 except for 

CHCBP. 

(2) Exceptions. The following 

individuals are not eligible to enroll in 

CHCBP: 

(i) Members of uniformed services, 

who are discharged or released from 

active duty either voluntarily or 

involuntarily under conditions that are 

adverse. 

(ii) Individuals who lost their 

eligibility or entitlement to care under 

10 U.S.C. chapter 55 or 10 U.S.C. 1145 

before October 1, 1994. 

(iii) Individuals who are locked out of 

other TRICARE programs per that 

program’s requirements. 

(3) Effective date. Eligibility in the 

CHCBP is limited to individuals who 

lost their entitlement to benefits under 

the MHS on or after October 1, 1994. 

The effective date of their coverage 

under CHCBP shall begin on the day 

after they cease to be eligible for care 

under 10 U.S.C. chapter 55 or 10 U.S.C. 

1145. 

(4) Notification of eligibility. 

(i) The Department of Defense and the 

other uniformed services (National 

Oceanic and Atmospheric 

Administration (NOAA), Public Health 

Service (PHS), and Coast Guard) will 

notify persons in the uniformed services 

eligible to receive health benefits under 

the CHCBP. In the case of a member 

who becomes (or will become) eligible 

for continued coverage, the Department 

of Defense shall notify the member of 

their rights for coverage as part of preseparation counseling conducted under 

10 U.S.C. 1142. 

(ii) In the case of a dependent of a 

member or former member who become 

eligible for continued coverage under 

paragraph (d)(1)(ii) of this section: 

(A) The member or former member 

may submit to the CHCBP contractor a 

notice with supporting documentation 

of the dependent’s change in status 

(including the dependent’s name, 

address, and such other information 

needed); and 

(B) The CHCBP contractor, within 

fourteen (14) days after receiving such 

information, will inform the dependent 

of the dependent’s rights under 

10 U.S.C. 1142. 

(iii) In the case of a former spouse of 

a member or former member who 

becomes eligible for continued coverage, 

the member, former member or former 

spouse may submit to the CHCBP 

contractor a notice of the former 

spouse’s change in status. The CHCBP 

contractor within fourteen (14) days 

after receiving such information will 

notify the individual of their potential 

eligibility for CHCBP. 

(5) Election of coverage. In order to 

obtain coverage under the CHCBP, a 

written election by the eligible 

beneficiary must be made within a 

prescribed time period. 

(i) In the case of a member discharged 

or released from active duty or full-time 

National Guard duty (whether 

voluntarily or involuntarily), or a RC 

member formerly eligible for care under 

10 U.S.C. chapter 55, the written 

election shall be submitted to the 

CHCBP contractor before the end of the 

60-day period beginning on the later of: 

(A) The date of the discharge or 

release of the member; or 

(B) The date that the period of 

transitional health care applicable to the 

member under 10 U.S.C. 1145(a) ends; 

or 

(C) The date the member receives the 

notification required in paragraph (d)(3) 

of this section. 

(ii) In the case of a child who ceases 

to meet the requirements for being an 

unremarried dependent child of a 

member or former member under 

10 U.S.C. 1072(2)(D) or an unmarried 

dependent of a member or former 

member of the uniformed services under 

10 U.S.C. 1072(2)(I), the written election 

shall be submitted to the CHCBP 

contractor before the end of the 60-day 

period beginning on the later of: 

(A) The date that the dependent 

ceases to meet the definition of a 

dependent under 10 U.S.C. 1072(2)(D) 

or 10 U.S.C. 1072(2)(I); or 

(B) The date that the dependent 

receives the notification required in 

paragraph (d)(3) of this section, 

(iii) In the case of former spouse of a 

member or former member, the written 

election shall be submitted to the 

CHCBP contractor before the end of the 

60-day period beginning on the date as 

of which the former spouse first ceases 

to meet the requirements for being 

considered a dependent under 10 U.S.C. 

1072(2). 

(iv) In the case of an unmarried 

surviving spouse of a member or former 

member of the uniformed services who 

on the day before the death of the 

member or former member was covered 

under 10 U.S.C. chapter 55 or 10 U.S.C. 

1145(a), the written election shall be 

submitted to the CHCBP contractor 

within 60 days of the date of the 

member or former member’s death. 

(v) A member of the uniformed 

services who is eligible for enrollment 

under paragraph (d)(1) of this section 

may elect self-only or family coverage. 

Family members who may be included 

in such family coverage are the spouse 

and children of the member. 

(vi) All other categories eligible for 

enrollment under paragraph (d)(1) of 

this section must elect self-only 

coverage. 

(6) Enrollment. To enroll in the 

CHCBP, an eligible individual must 

submit the completed enrollment form 

designated by the Director, TRICARE as 

well as any documentation as requested 

on the enrollment form to verify the 

applicant’s eligibility for enrolling in 

CHCBP, and payment to cover the 

quarter’s premium. The CHCBP 

contractor may request additional 

information and documentation to 

confirm the applicant’s eligibility for 

CHCBP. 

(7) Period of coverage. Except as 

noted below CHCBP coverage may not 

extend beyond 18 months from the date 

the individual becomes eligible for 

CHCBP. Although beneficiaries have 

sixty (60) days to elect coverage under 

the CHCBP, upon enrolling, the period 

of coverage must begin the day after 

entitlement or eligibility to a military 

health care plan ends as though no 

break in coverage had occurred 

notwithstanding the date the enrollment 

form with any applicable premium is 

submitted. 

(i) Exceptions: 

(A) In the case of a child of a member 

or former member, the date which is 

36 months after the date on which the 

person first ceases to meet the 

requirements for being considered an 

unmarried dependent child under 

10 U.S.C. 1072(2)(D) or 10 U.S.C. 

1072(2)(I). 

(B) In the case of an unremarried 

former spouse (as this term is defined in 

10 U.S.C. 1072(2)(G) or (H)) of a member 

or former member, the date which is 36 

months after the later of: 

(1) The date on which the final decree 

of divorce, dissolution, or annulment 

occurs; or 

(2) If applicable, the date the one-year 

extension of dependency under 

10 U.S.C. 1072(2)(H) expires. 

(C) In the case of an unremarried 

surviving spouse (widow or widower) 

(under 10 U.S.C. 1072(2)(B) or (C)) of a 

member or former member of the 

uniformed services who is not otherwise 

eligible for care under 10 U.S.C. chapter 

55, the date which is 36 months after 

the date the surviving spouse becomes 

ineligible under 10 U.S.C chapter 55 or 

10 U.S.C. 1145(a). 

(D) In the case of a former spouse of 

a retiree whose marriage was dissolved 

after the member retired from the 

service, the period of coverage under the 


erowe on DSK2VPTVN1PROD with RULES
Federal Register / Vol. 76, No. 180 / Friday, September 16, 2011 / Rules and Regulations 57641 

CHCBP is unlimited, if the former 

spouse: 

(1) Has not remarried before the age 

of 55 after the marriage to the former 

member was dissolved; and 

(2) Was enrolled in the CHCBP or 

TRICARE as the dependent of a retiree 

during the 18-month period before the 

date of the divorce, dissolution, or 

annulment; and 

(3) Is receiving a portion of the retired 

or retainer pay of a member or former 

member or an annuity based on the 

retainer pay of the member; or 

(4) Has a court order for payment of 

any portion of the retired or retainer pay 

or has a written agreement (whether 

voluntary or pursuant to a court order) 

which provides for an election by the 

member or former member to provide an 

annuity to the former spouse. 

(E) For the beneficiary who becomes 

eligible for the CHCBP by ceasing to 

meet the requirements for being 

considered an unmarried dependent 

child of a member or former member, 

health care coverage may not extend 

beyond the date which is 36 months 

after the date the member becomes 

ineligible for medical and dental care 

under 10 U.S.C. 1074(a) and any 

transitional health care under 10 U.S.C. 

1145(a). 

(e) CHCBP benefits. 

(1) In general. Except as provided in 

paragraph (e)(2) of this section, the 

provisions of § 199.4 shall apply to the 

CHCBP as they do to TRICARE. 

(2) Exceptions. The following 

provisions of § 199.4 are not applicable 

to the CHCBP: 

(i) Section 199.4(a)(2) concerning 

eligibility. 

(ii) All provisions regarding 

requirements to use facilities of the 

uniformed services because CHCBP 

enrollees are not eligible to use those 

facilities. 

(3) Beneficiary liability. For purposes 

of TRICARE deductible and cost-sharing 

requirements and catastrophic cap 

limits, amounts applicable to the 

category of beneficiaries to which the 

CHCBP enrollee last belonged shall 

continue to apply, except that for 

separating active duty members, 

amounts applicable to dependents of 

active duty members shall apply. 

(f) Authorized providers. The 

provisions of § 199.6 shall apply to the 

CHCBP as they do to TRICARE 

Standard. 

(g) Claims submission, review, and 

payment. The provisions of § 199.7 shall 

apply to the CHCBP as they do to 

TRICARE Standard except no provisions 

regarding nonavailability statements 

shall apply. 

(h) Double coverage. The provisions 

of § 199.8 shall apply to the CHCBP as 

they do to TRICARE Standard. 

(i) Administrative remedies for fraud, 

abuse, and conflict of interest. The 

provisions of § 199.9 shall apply to the 

CHCBP as they do to TRICARE 

Standard. 

(j) Appeal and hearing procedures. 

The provisions of § 199.10 shall apply to 

the CHCBP as they do to TRICARE 

Standard. 

(k) Overpayments recovery. The 

provisions of § 199.11 shall apply to the 

CHCBP as they do to TRICARE 

Standard. 

(l) Third party recoveries. The 

provisions of § 199.12 shall apply to the 

CHCBP as they do to TRICARE 

Standard. 

(m) Provider reimbursement methods. 

The provisions of § 199.14 shall apply to 

the CHCBP as they do to TRICARE 

Standard. 

(n) Quality and Utilization Review 

Peer Review Organization Program. The 

provisions of § 199.15 shall apply to the 

CHCBP as they do to TRICARE 

Standard. 

(o) Preferred provider organization 

programs available. Any preferred 

provider organization program under 

this part that provides for reduced cost 

sharing for using designated providers, 

such as the ‘‘TRICARE Extra’’ option 

under § 199.17, shall be available to 

participants in the CHCBP as it is to 

TRICARE Standard beneficiaries. 

(p) Special programs not applicable. 

(1) In general. Special programs 

established under this Part that are not 

part of the TRICARE Standard program 

established pursuant to 10 U.S.C. 1079 

and 1086 are not, unless specifically 

provided in this section, available to 

participants in the CHCBP. 

(2) Examples. The special programs 

referred to in paragraph (p)(1) of this 

section include but are not limited to: 

(i) The Extended Care Health Option 

under § 199.5; 

(ii) The TRICARE Dental Program or 

Retiree Dental Program under § 199.13 

and 199.22 respectively; 

(iii) The Supplemental Health Care 

Program under § 199.16; 

(iv) The TRICARE Program under 

§ 199.17, except for TRICARE Standard 

and Extra programs under that section; 

and 

(v) The Uniform HMO benefit under 

§ 199.18. 

(q) Premiums. 

(1) Rates. Premium rates will be 

established by the Assistant Secretary of 

Defense (Health Affairs) for two rate 

groups—individual and family. Eligible 

beneficiaries will select the level of 

coverage they require at the time of 

initial enrollment (either individual or 

family) and pay the appropriate 

premium payment. The rates are based 

on Federal Employees Health Benefits 

Program employee and agency 

contributions required for a comparable 

health benefits plan, plus an 

administrative fee. The administrative 

fee, not to exceed ten percent of the 

basic premium amount, shall be 

determined based on actual expected 

administrative costs for administration 

of the program. Premiums may be 

revised annually and shall be published 

when the premium amount is changed. 

Premiums will be paid by enrollees 

quarterly. 

(2) Effects of failure to make premium 

payments. Failure by enrollees to 

submit timely and proper premium 

payments will result in denial of 

continued enrollment and denial of 

payment of medical claims. Premium 

payments that are late thirty (30) days 

or more past the start of the quarter for 

which payment is due will result in the 

termination of beneficiary enrollment. 

Beneficiaries denied continued 

enrollment due to lack of premium 

payments will not be allowed to 

reenroll. In such a case, benefit coverage 

will cease at the end of the ninety (90) 

day period for which a premium 

payment was received. Enrollees will be 

held liable for medical costs incurred 

after losing eligibility. 

(r) Procedures. The Director, 

TRICARE Management Activity, may 

establish other rules and procedures for 

the administration of the CHCBP. 

■ 3. Section 199.24 is amended by 

removing and reserving paragraph (e) to 

read as follows: 

§ 199.24 TRICARE Reserve Select. 

* * * * * 

(e) [Reserved] 

* * * * * 

Dated: August 24, 2011. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2011–23760 Filed 9–15–11; 8:45 am] 

BILLING CODE 5001–06–P 


erowe on DSK2VPTVN1PROD with RULES