47452 Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations 

documents prepared by both HHS and 

DEA. 

Although the potency difference 

between BZP and amphetamine was 

discussed in the rules proposing and 

finalizing control of BZP as a part of the 

scientific background information, 

comparisons of potency differences are 

only one piece of background scientific 

data used to evaluate the abuse potential 

of drugs or other substances. In 

addition, potency itself is not one of the 

factors determinative of control. In fact, 

there are many examples of substances 

of varying potencies in each schedule, 

including stimulants and opiates 

previously scheduled under the CSA. 

Even though the scheduling of BZP 

was finalized more than six years ago, 

DEA has been advised that in criminal 

proceedings, for sentencing purposes, 

courts have sought to ascertain: (1) The 

controlled substance, for which a 

sentencing guideline equivalency exists, 

that is the most closely analogous to 

BZP (which is d-amphetamine) and 

(2) the relative potency of BZP to that 

of the most analogous controlled 

substance. As indicated above, DEA has 

already published on the agency’s Web 

site the correct figures regarding relative 

potency. This correction is being issued 

to provide such an official statement in 

the Federal Register for ease of 

reference by courts, litigants, and others 

who need the information for 

sentencing purposes. 

This correction does not address the 

scheduling of 2,5-dimethoxy-4-(n)- 

propylthiophenethylamine (2C–T–7) 

which was also placed into schedule I 

as a result of the above cited 

rulemakings. 

Correction 

Accordingly, the publication on 

Thursday, March 18, 2004, of the Final 

Rule [Docket No. DEA–247F], at 69 FR 

12794 [FR Doc. 04–6110], is corrected in 

the preamble as follows: 

On page 12795, in the first column, 

paragraph 4, sentences 4 and 5 are 

corrected to read as follows: ‘‘BZP is 

about 20 times less potent than 

amphetamine in producing these effects. 

However, in subjects with a history of 

amphetamine dependence, BZP was 

found to be about 10 times less potent 

than amphetamine.’’ 

Dated: July 26, 2010. 

Michele M. Leonhart, 

Deputy Administrator. 

[FR Doc. 2010–19348 Filed 8–5–10; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[Docket ID: DoD–2010–HA–0068] 

RIN 0720–AB39 

Civilian Health and Medical Program of 

the Uniformed Services (CHAMPUS); 

TRICARE Retired Reserve for Members 

of the Retired Reserve 

AGENCY: Office of the Secretary, DoD. 

ACTION: Interim final rule with comment 

period. 

SUMMARY: This interim final rule 

establishes requirements and 

procedures for implementation of 

TRICARE Retired Reserve. This interim 

final rule addresses provisions of the 

National Defense Authorization Act for 

Fiscal Year 2010 (NDAA–10). The 

purpose of this interim final rule is to 

establish the TRICARE Retired Reserve 

program that implements section 705 of 

the NDAA–10. Section 705 allows 

members of the Retired Reserve who are 

qualified for non-regular retirement, but 

are not yet 60 years of age, to qualify to 

purchase medical coverage equivalent to 

the TRICARE Standard (and Extra) 

benefit unless that member is either 

enrolled in, or is eligible to enroll in, a 

health benefit plan under Chapter 89 of 

Title 5, United States Code, as well as 

certain survivors. The amount of the 

premium that qualified members pay to 

purchase these benefits will represent 

the full cost as determined on an 

appropriate actuarial basis for coverage 

under the TRICARE Standard (and 

Extra) benefit including the cost of the 

program administration. There will be 

one premium for member-only coverage 

and a separate premium for member and 

family coverage. The rules and 

procedures otherwise outlined in Part 

199 of 32 CFR relating to the operation 

and administration of the TRICARE 

Standard and Extra programs including 

the required cost-shares, deductibles 

and catastrophic caps for retired 

members and their dependents will 

apply to this program. The rule is being 

published as an interim final rule with 

comment period in order to comply 

with statutory effective dates. 

DATES: This rule is effective August 6, 

2010. Written comments received at the 

address indicated below by October 5, 

2010 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 RIN 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. 

FOR FURTHER INFORMATION CONTACT: Jody 

Donehoo, TRICARE Management 

Activity, TRICARE Policy and 

Operations, 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 Retired 

Reserve program that implements 

section 705 of the National Defense 

Authorization Act for Fiscal Year 2010 

(NDAA–10) (Pub. L. 111–84). Section 

705 added new section 1076e to Title 

10, United States Code. Section 1076e 

allows members of the Retired Reserve 

who are qualified for non-regular 

retirement, but are not yet 60 years of 

age, as well as certain survivors to 

qualify to purchase medical coverage 

equivalent to the TRICARE Standard 

(and Extra) benefit unless that member 

is either enrolled in, or eligible to enroll 

in, a health benefits plan under Chapter 

89 of Title 5, United States Code. 

II. Provisions of the Rule Regarding the 

TRICARE Retired Reserve Program 

A. Establishment of the TRICARE 

Retired Reserve Program (paragraph 

199.25(a)). This paragraph describes the 

nature, purpose, statutory basis, scope, 

and major features of TRICARE Retired 

Reserve, a premium-based medical 

coverage program that was made 

available for purchase worldwide by 

certain members of the Retired Reserve, 

their family members and their 

surviving family members. TRICARE 

Retired Reserve is authorized by 10 

U.S.C. 1076e. 

The major features of the program 

include making coverage available for 

purchase by any Retired Reserve 

member who is qualified for non-regular 


erowe on DSK5CLS3C1PROD with RULES
Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations 47453 

retirement, but is not yet 60 years of age, 

unless that member is either enrolled in, 

or eligible to enroll in, a health benefit 

plan under Chapter 89 of Title 5, United 

States Code, as well as certain survivors 

of Retired Reserve members as specified 

below. The amount of the premium that 

qualified members and qualified 

survivors pay is prescribed by the 

Assistant Secretary of Defense for 

Health Affairs (ASD(HA)) and 

determined using an appropriate 

actuarial basis. There is one premium 

for member-only coverage and a second 

premium for member and family 

coverage. Additionally, TRICARE rules 

outlined in Part 199 of Title 32 of the 

CFR relating to the TRICARE Standard 

and Extra programs apply unless 

otherwise specified. Certain special 

TRICARE programs are not part of 

TRICARE Retired Reserve including the 

Extended Health Care Option (ECHO) 

program and the Supplemental Health 

Care Program (see § 199.16) except 

when referred by a Military Treatment 

Facility (MTF) provider for incidental 

consults and the MTF provider 

maintains clinical control over the 

episode of care. The TRICARE Retiree 

Dental Program is already available 

independently for purchase by Retired 

Reserve members under 10 U.S.C. 1076c 

as implemented by 32 CFR 199.22. 

Under TRICARE Retired Reserve, 

qualified members (or their qualified 

survivors) may purchase either the 

member-only type of coverage or the 

member and family type of 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 their 

coverage becomes effective, TRICARE 

Retired Reserve beneficiaries receive the 

TRICARE Standard (and Extra) benefit. 

TRICARE Retired Reserve features the 

deductible and cost sharing provisions 

of the TRICARE Standard (and Extra) 

plan for retired members and 

dependents of retired members. Both 

the member and the member’s covered 

family members are provided access 

priority for care in military treatment 

facilities on the same basis as retired 

members and their family members who 

are not enrolled in TRICARE Prime. 

B. Qualifications for TRICARE Retired 

Reserve coverage (paragraph 199.25(b)). 

This paragraph defines the statutory 

conditions under which members of a 

Reserve component may qualify to 

purchase TRICARE Retired Reserve 

coverage. The Reserve components of 

the armed forces have the responsibility 

to determine and validate a member’s 

qualifications to purchase TRICARE 

Retired Reserve coverage. The member’s 

Service personnel office is responsible 

for keeping the Defense Enrollment 

Eligibility Reporting System (DEERS) 

current with eligibility data. 

A member qualifies to purchase 

TRICARE Retired Reserve coverage if 

the member meets both of the following 

conditions: 

(a) is a member of the Retired Reserve 

of a Reserve component of the armed 

forces who is qualified for a non-regular 

retirement at age 60 under chapter 1223 

of title 10, U.S.C., but is not age 60; and 

(b) is not enrolled, or eligible to 

enroll, in a health benefits plan under 

chapter 89 of title 5 U.S.C. 

If a qualified member of the Retired 

Reserve dies while in a period of 

TRICARE Retired Reserve coverage, the 

immediate family member(s) of such 

member shall remain qualified to 

continue existing or purchase new 

TRICARE Retired Reserve coverage until 

the date on which the deceased member 

of the Retired Reserve would have 

attained age 60 as long as they meet the 

definition of immediate family member 

specified below. This applies regardless 

of whether either member-only coverage 

or member and family coverage was in 

effect on the day of the TRICARE 

Retired Reserve member’s death. 

C. TRICARE Retired Reserve 

premiums (paragraph 199.25(c)). 

Members are charged premiums for 

coverage under TRICARE Retired 

Reserve that represent the full cost of 

providing the TRICARE Standard (and 

Extra) benefit under this program. The 

total annual premium amounts shall be 

determined by the ASD(HA) using an 

appropriate actuarial basis and are 

established and updated annually, on a 

calendar year basis, by the ASD(HA) for 

qualified members of the Retired 

Reserve for each of the two types of 

coverage, member-only coverage and 

member-and-family coverage. 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. 

A surviving family member of a 

Retired Reserve member who qualified 

for TRICARE Retired Reserve coverage 

as described herein will pay premium 

rates at the member-only rate if there is 

only one surviving family member to be 

covered by TRICARE Retired Reserve 

and at the member and family rate if 

there are two or more survivors to be 

covered. 

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 Retired Reserve as 

determined by the ASD(HA). TRICARE 

Retired Reserve premiums shall be 

based on the actual costs of providing 

benefits to TRICARE Retired Reserve 

members and their family members 

during the preceding years if the 

population of Retired Reserve members 

enrolled in TRICARE Retired Reserve 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 Retired 

Reserve premiums shall be based on the 

actual costs during the preceding 

calendar years for providing benefits to 

the population of retired members and 

their family members in the same age 

categories as the Retired Reserve 

population 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 

or any actual experience in the costs of 

administering the TRICARE Retired 

Reserve program. 

A surviving family member of a 

Retired Reserve member who qualified 

for TRICARE Retired Reserve coverage 

as described herein will pay premium 

rates at the member-only rate if there is 

only one surviving family member to be 

covered by TRICARE Retired Reserve 

and at the member and family rate if 

there are two or more survivors to be 

covered. 

For the portion of calendar year 2010 

during which the program is in effect, 

the monthly premium for member-only 

coverage will be $388.31/month (annual 

premium $4,659.72/year), and the 

monthly premium for member and 

family coverage will be $976.41/month 

(annual premium $11,716.92/year). The 

2010 premiums are based on the actual 

costs during calendar years 2007 and 

2008 for providing benefits to the 

population of retired members and their 

family members in the same age 

categories as the Retired Reserve 

population in order to make the 

underlying group actuarially 

appropriate. The historical costs were 

trended forward to 2010 and a twopercent adjustment was applied to cover 

overhead costs for administration of the 

program by the government. 

For calendar year 2011, the monthly 

premium for member-only coverage will 

be $408.01/month (annual premium 

$4,896.12/year), and the monthly 

premium for member and family 

coverage will be $1,020.05/month 

(annual premium $12,240.60/year). The 

2011 premiums are based on the actual 

costs during calendar years 2008 and 


erowe on DSK5CLS3C1PROD with RULES
47454 Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations 

2009 for providing benefits to the 

population of retired members and their 

family members in the same age 

categories as the Retired Reserve 

population in order to make the 

underlying group actuarially 

appropriate. The historical costs were 

trended forward to 2011 and a twopercent adjustment was applied to cover 

overhead costs for administration of the 

program by the government. 

D. Procedures (paragraph 199.25(d)). 

The Director, TRICARE Management 

Activity (TMA), may establish 

procedures for the following: 

—Purchasing Coverage. Procedures may 

be established for a qualified member, 

including surviving family members, 

to purchase one of two types of 

coverage: Member-only coverage or 

member-and-family coverage. 

Immediate family members of the 

Retired Reserve member may be 

included in such family coverage. To 

purchase either type of TRICARE 

Retired Reserve coverage, Retired 

Reserve members or their survivors 

qualified as above must complete and 

submit a request in the appropriate 

format, along with an initial payment 

of the applicable premium required 

above. 

—Continuation Coverage. Procedures 

may be established for a qualified 

member or qualified survivor to 

purchase TRICARE Retired Reserve 

coverage with an effective date 

immediately following the date of 

termination of coverage under another 

TRICARE program. 

—Qualifying Life Event. Procedures may 

be established for a qualified member 

or qualified survivor to purchase 

TRICARE Retired Reserve coverage on 

the occasion of a qualifying life event 

that changes the immediate family 

composition (e.g., birth, death, 

adoption, divorce, etc.). The effective 

date for TRICARE Retired Reserve 

coverage will coincide with the day of 

the qualifying life event. It is the 

responsibility of the member to 

provide personnel officials with the 

necessary evidence required to 

substantiate the change in immediate 

family composition. Personnel 

officials will update DEERS in the 

usual manner. Appropriate action will 

be taken upon receipt of the 

completed request in the appropriate 

format along with an initial payment 

of the applicable premium in 

accordance with established 

procedures. 

—Open Enrollment. Procedures may be 

established for a qualified member or 

qualified survivor to purchase 

TRICARE Retired Reserve coverage at 

any time. The effective date of 

coverage will coincide with the first 

day of a month. 

—Survivor coverage under TRICARE 

Retired Reserve. Procedures may be 

established for a surviving family 

member of a Retired Reserve member 

who qualified for TRICARE Retired 

Reserve coverage as described above 

to continue existing or to purchase 

new TRICARE Retired Reserve 

coverage. Procedures similar to those 

for qualifying life events may be 

established for a qualified surviving 

family member to purchase new or 

continuing coverage with an effective 

date coinciding with the day of the 

member’s death. Procedures similar to 

those for open enrollment may be 

established for a qualified surviving 

family member to purchase new 

coverage at any time with an effective 

date coinciding with the first day of 

a month. 

—Changing type of coverage. 

Procedures may be established for 

TRICARE Retired Reserve members or 

qualified survivors to request to 

change type of coverage during open 

enrollment or on the occasion of a 

qualifying life event that changes 

immediate family composition as 

described above by submitting a 

completed request in the appropriate 

format. 

—Termination. Termination of coverage 

for the member will result in 

termination of coverage for the 

member’s family members in 

TRICARE Retired Reserve, except for 

qualified survivors as described 

above. 

—Coverage will terminate whenever a 

member (or qualified survivors) 

ceases to meet the qualifications for 

the program. For purposes of this 

section, the member no longer 

qualifies for TRICARE Retired Reserve 

when the member has been eligible 

for more than 60 days for coverage in 

a health benefits plan under Chapter 

89 of Title 5, U.S.C. This affords the 

member sufficient time to make 

arrangements for health coverage and 

avoid any lapses in health coverage. 

Further, coverage shall terminate 

when the Retired Reserve member 

attains the age of 60 or, if survivor 

coverage is in effect, when the 

deceased Retired Reserve member 

would have attained the age of 60. 

—Coverage may terminate for members 

who gain coverage under another 

TRICARE program. 

—Failure to make a premium payment 

in a timely manner in accordance 

with established procedures will 

result in termination of coverage for 

the member and any covered family 

members and will result in denial of 

claims for services with a date of 

service after the effective date of 

termination. 

—Procedures may be established for 

covered members and survivors to 

request termination of coverage at any 

time by submitting a completed 

request in the appropriate format. 

—Members whose coverage under 

TRICARE Retired Reserve terminates 

upon their request or for failure to pay 

premiums will not be allowed to 

purchase coverage under TRICARE 

Retired Reserve to begin again for a 

period of one year following the 

effective date of termination. 

—Processing. Upon receipt of a 

completed request in the appropriate 

format, the appropriate enrollment 

actions will be processed into DEERS 

in accordance with established 

procedures. 

—Periodic revision. Periodically, certain 

features, rules or procedures of 

TRICARE Retired Reserve may be 

revised. If such revisions will have a 

significant effect on members’ or 

survivors’ costs or access to care, 

members or survivors may be given 

the opportunity to change their type 

of coverage or terminate coverage 

coincident with the revisions. 

E. Preemption of State laws 

(paragraph 199.25(e)). This paragraph 

explains that the preemptions of State 

and local laws established for the 

TRICARE program also apply to 

TRICARE Retired Reserve. 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 Retired 

Reserve. 

This includes State and local laws 

imposing premium taxes on health 

insurance carriers, underwriters or other 

plan managers, or similar taxes on such 

entities. Preemption does not apply to 

taxes, fees, or other payments on net 

income or profit realized by such 

entities in the conduct of business 

relating to DoD health services 

contracts, if those taxes, fees or other 

payments are applicable to a broad 

range of business activity. For the 

purposes of assessing the effect of 

Federal preemption of State and local 

taxes and fees in connection with DoD 

health services contracts, interpretations 

shall be consistent with those applicable 

to the Federal Employees Health 

Benefits Program under 5 U.S.C. 8909(f). 

F. Administration (paragraph 

199.25(f)). This paragraph provides that 

the Director, TRICARE Management 

Activity, may establish other rules and 


erowe on DSK5CLS3C1PROD with RULES
Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations 47455 

procedures necessary for the effective 

administration of TRICARE Retired 

Reserve and may authorize exceptions 

to requirements of this section, if 

permitted by law, based on 

extraordinary circumstances. 

G. Terminology. The following terms 

are applicable to the TRICARE Retired 

Reserve program. 

—Coverage. This term means the 

medical benefits covered under the 

TRICARE Standard or Extra programs 

as further outlined in other sections of 

part 199 of Title 32 of the Code of 

Federal Regulations, whether 

delivered in military treatment 

facilities or purchased from civilian 

sources. 

—Immediate family member. This term 

means spouse (except former spouse) 

as defined in paragraph 199.3(b)(2)(i) 

of this part, or child as defined in 

paragraph 199.3 (b)(2)(ii). 

—Qualified member. This term means a 

member who has satisfied all the 

criteria that must be met before the 

member is authorized for TRR 

coverage. 

—Qualified survivor. This term means 

an immediate family member who has 

satisfied all the criteria that must be 

met before the survivor is authorized 

for TRR coverage. 

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 is not 

subject to any of those requirements 

because it would not have any of these 

substantial impacts. 

This rule will not impose additional 

information collection requirements on 

the public under the Paperwork 

Reduction Act of 1995 (44 U.S.C. 3501– 

3511). 

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 soliciting public comment under a 

proposed rule first, in order to comply 

with the requirements of the National 

Defense Authorization Act for Fiscal 

Year 2010, Public Law 110–417, section 

705, which was enacted on October 28, 

2009. This section provides in pertinent 

part that this provision applies ‘‘to 

coverage for months beginning on or 

after October 1, 2009.’’ In order to 

provide coverage as soon possible 

consistent with statutory entitlement, 

the ASD(HA) has determined that 

obtaining prior public comment 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 at the appropriate place in 

alphabetical order the definition of 

‘‘TRICARE Retired Reserve’’ to read as 

follows: 

§ 199.2 Definitions. 

* * * * * 

(b) * * * 

TRICARE Retired Reserve. The 

program established to allow members 

of the Retired Reserve who are qualified 

for non-regular retirement, but are not 

yet 60 years of age, as well as certain 

survivors to qualify to purchase medical 

coverage equivalent to the TRICARE 

Standard (and Extra) benefit unless that 

member is either enrolled in, or eligible 

to enroll in, a health benefit plan under 

Chapter 89 of Title 5, United States 

Code. The program benefits and 

requirements are set forth in section 25 

of this Part. 

* * * * * 

■ 3. Section 199.25 is added as follows: 

§ 199.25 TRICARE Retired Reserve. 

(a) Establishment. TRICARE Retired 

Reserve is established for the purpose of 

offering the medical benefits provided 

under the TRICARE Standard and Extra 

programs to qualified members of the 

Retired Reserve, their immediate family 

members, and qualified survivors. 

(1) Purpose. As specified in paragraph 

(c) of this section, TRICARE Retired 

Reserve is a premium-based health plan 

that is available for purchase by any 

Retired Reserve member who is 

qualified for non-regular retirement, but 

is not yet 60 years of age, unless that 

member is either enrolled in, or eligible 

to enroll in, a health benefit plan under 

Chapter 89 of Title 5, United States 

Code, as well as certain survivors of 

Retired Reserve members. 

(2) Statutory Authority. TRICARE 

Retired Reserve is authorized by 10 

U.S.C. 1076e. 

(3) Scope of the Program. TRICARE 

Retired Reserve is geographically 

applicable to the same extent as 

specified in 32 CFR 199.1(b)(1). 

(4) Major Features of TRICARE 

Retired Reserve. The major features of 

the program include the following: 

(i) TRICARE rules applicable. (A) 

Unless specified in this section or 

otherwise prescribed by the ASD (HA), 

provisions of 32 CFR part 199 apply to 

TRICARE Retired Reserve. 

(B) Certain special programs 

established in 32 CFR part 199 are not 

available to members covered under 

TRICARE Retired Reserve. These 

include the Extended Health Care 

Option (ECHO) program and the 

Supplemental Health Care Program (see 

§ 199.16) except when referred by a 

Military Treatment Facility (MTF) 

provider for incidental consults and the 

MTF provider maintains clinical control 

over the episode of care. The TRICARE 

Retiree Dental Program (see § 199.13) is 

independent of this program and is 

otherwise available to all members who 

qualify for the TRICARE Retiree Dental 

Program whether or not they purchase 

TRICARE Retired Reserve coverage. The 

Continued Health Care Benefits Program 

(see § 199.13) is also independent of this 

program and is otherwise available to all 

members who qualify for the Continued 

Health Care Benefits Program. 

(ii) Premiums. TRICARE Retired 

Reserve coverage is available for 

purchase by any Retired Reserve 

member if the member fulfills all of the 

statutory qualifications as well as 

certain survivors. A member of the 

Retired Reserve or qualified survivor 

covered under TRICARE Retired 

Reserve shall pay the amount equal to 

the total amount that the ASD(HA) 

determines on an appropriate actuarial 

basis as being appropriate for that 

coverage. There is one premium rate for 

member-only coverage and one 


erowe on DSK5CLS3C1PROD with RULES
47456 Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations 

premium rate for member and family 

coverage. 

(iii) Procedures. Under TRICARE 

Retired Reserve, Retired Reserve 

members (or their survivors) who 

fulfilled all of the statutory 

qualifications may purchase either the 

member-only type of coverage or the 

member and family type of 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 this section. 

(iv) Benefits. When their coverage 

becomes effective, TRICARE Retired 

Reserve beneficiaries receive the 

TRICARE Standard (and Extra) benefit 

including access to military treatment 

facilities on a space available basis and 

pharmacies, as described in § 199.17 of 

this part. TRICARE Retired Reserve 

coverage features the deductible and 

cost share provisions of the TRICARE 

Standard (and Extra) plan for retired 

members and dependents of retired 

members. Both the member and the 

member’s covered family members are 

provided access priority for care in 

military treatment facilities on the same 

basis as retired members and their 

dependents who are not enrolled in 

TRICARE Prime as described in 

paragraph 199.17(d)(1)(E) of this Part. 

(b) Qualifications for TRICARE 

Retired Reserve coverage—(1) Retired 

Reserve Member. A Retired Reserve 

member qualifies to purchase TRICARE 

Retired Reserve coverage if the member 

meets both the following criteria: 

(i) Is a member of a Reserve 

component of the armed forces who is 

qualified for a non-regular retirement at 

age 60 under chapter 1223 of title 10, 

U.S.C., but who is not yet age 60 and 

(ii) Is not enrolled in, or eligible to 

enroll in, a health benefits plan under 

chapter 89 of title 5, U.S.C. 

(2) Retired Reserve Survivor. If a 

qualified member of the Retired 

Reserves dies while in a period of 

TRICARE Retired Reserve coverage, the 

immediate family member(s) of such 

member shall remain qualified to 

purchase new or continue existing 

TRICARE Retired Reserve coverage until 

the date on which the deceased member 

of the Retired Reserve would have 

attained age 60 as long as they meet the 

definition of immediate family members 

specified in paragraph (g)(2) of this 

section. This applies regardless whether 

either member-only coverage or member 

and family coverage was in effect on the 

day of the TRICARE Retired Reserve 

member’s death. 

(c) TRICARE Retired Reserve 

premiums. Members are charged 

premiums for coverage under TRICARE 

Retired Reserve that represent the full 

cost of the program as determined by 

the ASD(HA) utilizing an appropriate 

actuarial basis for the provision of the 

benefits provided under the TRICARE 

Standard and Extra programs for the 

TRICARE Retired Reserve eligible 

beneficiary population. Premiums are to 

be paid monthly. The monthly rate for 

each month of a calendar year is onetwelfth of the annual rate for that 

calendar year. 

(1) Annual establishment of rates. 

(i) TRICARE Retired Reserve monthly 

premium rates shall be established and 

updated annually on a calendar year 

basis by the ASD(HA) for each of the 

two types of coverage, member-only 

coverage and member-and-family 

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 the 

same demographic population as those 

enrolled in TRICARE Retired Reserve as 

determined by the ASD(HA). TRICARE 

Retired Reserve premiums shall be 

based on the actual costs of providing 

benefits to TRICARE Retired Reserve 

members and their dependents during 

the preceding years if the population of 

Retired Reserve members enrolled in 

TRICARE Retired Reserve is large 

enough during those preceding years to 

be considered actuarially appropriate. 

Until such time that actual costs from 

those preceding years becomes 

available, TRICARE Retired Reserve 

premiums shall be based on the actual 

costs during the preceding calendar 

years for providing benefits to the 

population of retired members and their 

dependents in the same age categories 

as the retired reserve population 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. 

(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 

or any actual experience in the costs of 

administering the TRICARE Retired 

Reserve Program. 

(3) Survivor Premiums. A surviving 

family member of a Retired Reserve 

member who qualified for TRICARE 

Retired Reserve coverage as described 

herein will pay premium rates at the 

member-only rate if there is only one 

surviving family member to be covered 

by TRICARE Retired Reserve and at the 

member-and-family rate if there are two 

or more survivors to be covered. 

(d) Procedures. The Director, 

TRICARE Management Activity (TMA), 

may establish procedures for the 

following. 

(1) Purchasing Coverage. Procedures 

may be established for a qualified 

member to purchase one of two types of 

coverage: member-only coverage or 

member and family coverage. Immediate 

family members of the Retired Reserve 

member may be included in such family 

coverage. To purchase either type of 

TRICARE Retired Reserve coverage for 

effective dates of coverage described 

below, Retired Reserve members and 

survivors qualified under either 

paragraph (b)(1) or (b)(2) of this section 

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 for a qualified 

member or qualified survivor to 

purchase TRICARE Retired Reserve 

coverage with an effective date 

immediately following the date of 

termination of coverage under another 

TRICARE program. 

(ii) Qualifying Life Event. Procedures 

may be established for a qualified 

member or qualified survivor to 

purchase TRICARE Retired Reserve 

coverage on the occasion of a qualifying 

life event that changes the immediate 

family composition (e.g., birth, death, 

adoption, divorce, etc.) that is eligible 

for coverage under TRICARE Retired 

Reserve. The effective date for TRICARE 

Retired Reserve coverage will coincide 

with the date of the qualifying life 

event. It is the responsibility of the 

member to provide personnel officials 

with the necessary evidence required to 

substantiate the change in immediate 

family composition. Personnel officials 

will update DEERS in the usual manner. 

Appropriate action will be taken upon 

receipt of the completed request in the 

appropriate format along with an initial 

payment of the applicable premium in 

accordance with established procedures. 

(iii) Open Enrollment. Procedures 

may be established for a qualified 

member or qualified survivor to 

purchase TRICARE Retired Reserve 

coverage at any time. The effective date 

of coverage will coincide with the first 

day of a month. 

(iv) Survivor coverage under TRICARE 

Retired Reserve. Procedures may be 

established for a surviving family 

member of a qualified Retired Reserve 

member who qualified for TRICARE 

Retired Reserve coverage as described in 

paragraph (b)(2) of this section to 


erowe on DSK5CLS3C1PROD with RULES
Federal Register / Vol. 75, No. 151 / Friday, August 6, 2010 / Rules and Regulations 47457 

purchase new TRICARE Retired Reserve 

coverage or continue existing TRICARE 

Retired Reserve coverage. Procedures 

similar to those for qualifying life events 

may be established for a qualified 

surviving family member to purchase 

new or continuing coverage with an 

effective date coinciding with the day of 

the member’s death. Procedures similar 

to those for open enrollment may be 

established for a qualified surviving 

family member to purchase new 

coverage at any time with an effective 

date coinciding with the first day of a 

month. 

(2) Changing type of coverage. 

Procedures may be established for 

TRICARE Retired Reserve members/ 

survivors to request to change type of 

coverage during open enrollment as 

described in paragraph (d)(1)(iii) of this 

section or on the occasion of a 

qualifying life event that changes 

immediate family composition as 

described in paragraph (d)(1)(ii) of this 

section by submitting a completed 

request in the appropriate format. 

(3) Termination. Termination of 

coverage for the member will result in 

termination of coverage for the 

member’s family members in TRICARE 

Retired Reserve, except as described in 

paragraphs (d)(1)(iv) of this section. The 

termination will become effective in 

accordance with established procedures. 

(i) Coverage shall terminate for 

members or their survivors who no 

longer qualify for TRICARE Retired 

Reserve as specified in paragraph (c) of 

this section. For purposes of this 

section, the member or their survivor no 

longer qualifies for TRICARE Retired 

Reserve when the member has been 

eligible for coverage in a health benefits 

plan under Chapter 89 of Title 5, U.S.C. 

for more than 60 days. Further, coverage 

shall terminate when the Retired 

Reserve member attains the age of 60 or, 

if survivor coverage is in effect, when 

the deceased Retired Reserve member 

would have attained the age of 60. 

(ii) Coverage may terminate for 

members and survivors who gain 

coverage under another TRICARE 

program. 

(iii) Coverage shall terminate for 

members and survivors who fail to make 

a premium payment in accordance with 

established procedures. 

(iv) Procedures may be established for 

covered members and survivors to 

request termination of coverage at any 

time by submitting a completed request 

in the appropriate format. 

(v) Members or qualified survivors 

whose coverage under TRICARE Retired 

Reserve terminates under paragraph 

(d)(3)(iii) or (d)(3)(iv) of this section will 

not be allowed to purchase coverage 

under TRICARE Retired Reserve to 

begin again for a period of one year 

following the effective the date of 

termination. 

(4) Processing. Upon receipt of a 

completed request in the appropriate 

format, enrollment actions will be 

processed into DEERS in accordance 

with established procedures. 

(5) Periodic revision. Periodically, 

certain features, rules or procedures of 

TRICARE Retired Reserve may be 

revised. If such revisions will have a 

significant effect on members’ or 

survivors’ costs or access to care, 

members or survivors may be given the 

opportunity to change their type of 

coverage or terminate coverage 

coincident with the revisions. 

(e) Preemption of State laws.— 

(1) Pursuant to 10 U.S.C. 1103, the 

Department of Defense has determined 

that in the administration of chapter 55 

of title 10, U.S. Code, preemption of 

State and local laws relating to health 

insurance, prepaid health plans, or 

other health care delivery or financing 

methods is necessary to achieve 

important Federal interests, including 

but not limited to the assurance of 

uniform national health programs for 

military families and the operation of 

such programs, at the lowest possible 

cost to the Department of Defense, that 

have a direct and substantial effect on 

the conduct of military affairs and 

national security policy of the United 

States. This determination is applicable 

to contracts that implement this section. 

(2) Based on the determination set 

forth in paragraph (f)(1) of this section, 

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 

Retired Reserve. Any such law, or 

regulation pursuant to such law, is 

without any force or effect, and State or 

local governments have no legal 

authority to enforce them in relation to 

TRICARE Retired Reserve. (However, 

the Department of Defense may, by 

contract, establish legal obligations on 

the part of DoD contractors to conform 

with requirements similar to or identical 

to requirements of State or local laws or 

regulations with respect to TRICARE 

Retired Reserve). 

(3) The preemption of State and local 

laws set forth in paragraph (f)(2) of this 

section includes State and local laws 

imposing premium taxes on health 

insurance carriers or underwriters or 

other plan managers, or similar taxes on 

such entities. Such laws are laws 

relating to health insurance, prepaid 

health plans, or other health care 

delivery or financing methods, within 

the meaning of 10 U.S.C. 1103. 

Preemption, however, does not apply to 

taxes, fees, or other payments on net 

income or profit realized by such 

entities in the conduct of business 

relating to DoD health services 

contracts, if those taxes, fees or other 

payments are applicable to a broad 

range of business activity. For the 

purposes of assessing the effect of 

Federal preemption of State and local 

taxes and fees in connection with DoD 

health services contracts, interpretations 

shall be consistent with those of the 

Federal Employees Health Benefits 

Program under 5 U.S.C. 8909(f). 

(f) Administration. The Director, 

TRICARE Management Activity, may 

establish other rules and procedures for 

the effective administration of TRICARE 

Retired Reserve and may authorize 

exceptions to requirements of this 

section, if permitted by law, based on 

extraordinary circumstances. 

(g) Terminology. The following terms 

are applicable to the TRICARE Retired 

Reserve program. 

(1) Coverage. This term means the 

medical benefits covered under the 

TRICARE Standard or Extra programs as 

further outlined in other sections of Part 

199 of Title 32 of the Code of Federal 

Regulations, whether delivered in 

military treatment facilities or 

purchased from civilian sources. 

(2) Immediate family member. This 

term means spouse (except former 

spouses) as defined in paragraph 

199.3(b)(2)(i) of this part, or child as 

defined in paragraph 199.3 (b)(2)(ii). 

(3) Qualified member. This term 

means a member who has satisfied all 

the criteria that must be met before the 

member is authorized for TRR coverage. 

(4) Qualified survivor. This term 

means an immediate family member 

who has satisfied all the criteria that 

must be met before the survivor is 

authorized for TRR coverage. 

Dated: July 26, 2010. 

Patricia L. Toppings, 

OSD Federal Register Liaison Officer, 

Department of Defense. 

[FR Doc. 2010–19313 Filed 8–5–10; 8:45 am] 

BILLING CODE 5001–06–P 


erowe on DSK5CLS3C1PROD with RULES