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[Federal Register: April 29, 2010 (Volume 75, Number 82)]
[Notices]               
[Page 22556]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr29ap10-28]                         

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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket No. DOD-2009-HA-0159]

 
Submission for OMB Review; Comment Request

ACTION: Notice.

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    The Department of Defense has submitted to OMB for clearance, the 
following proposal for collection of information under the provisions 
of the Paperwork Reduction Act (44 U.S.C. Chapter 35).

DATES: Consideration will be given to all comments received by June 1, 
2010.
    Title and OMB Number: TRICARE Prime Enrollment Application/PCM 
Change Form DD Form 2876, and TRICARE Prime Disenrollment Application; 
DD Form 2877; OMB Number 0720-0008.
    Type of Request: Extension.
    Number of Respondents: 72,905.
    Responses per Respondent: 1.
    Annual Responses: 72,905.
    Average Burden per Response: 18.367 minutes (average).
    Annual Burden Hours: 22,317 hours.
    Needs and Uses: This information is collected in accordance with 
the National Defense Authorization Act for Fiscal Year 2001 (Pub. L. 
106-398), section 723(b)(E)). These collection instruments serve as 
applications for the Enrollment, Primary Care Manager (PCM) Change and 
Disenrollment for the Department of Defense's TRICARE Prime program 
established in accordance with title 10 U.S.C. 1099 (which calls for a 
healthcare enrollment system). Monthly payment options for retiree 
enrollment fees for TRICARE Prime are established in accordance with 
title 10 U.S.C. 1097a(c). The information collected on the TRICARE 
Prime Enrollment Application/PCM Change Form provides the necessary 
data to determine beneficiary eligibility, to identify the selection of 
a health care option, and to change the designated PCM when the 
beneficiary is relocating or merely requests a local PCM change. The 
information collected on the TRICARE Prime Disenrollment Form provides 
the necessary data to disenroll a beneficiary from TRICARE Prime. The 
Disenrollment Application is needed to implement disenrollment from 
TRICARE Prime, TRICARE Prime Remote or the Uniformed Services Family 
Health Plan as requested by the enrollee. Failure to provide 
information will result in continued enrollment and beneficiaries' 
responsibility for payment of an enrollment fee.
    Affected Public: Individuals or households.
    Frequency: On occasion.
    Respondent's Obligation: Required to obtain or retain benefits.
    OMB Desk Officer: Mr. John Kraemer.
    Written comments and recommendations on the proposed information 
collection should be sent to Mr. Kraemer at the Office of Management 
and Budget, Desk Officer for DoD, Room 10236, New Executive Office 
Building, Washington, DC 20503.
    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.
    DOD Clearance Officer: Ms. Patricia Toppings.
    Written requests for copies of the information collection proposal 
should be sent to Ms. Toppings at WHS/ESD/Information Management 
Division, 1777 North Kent Street, RPN, Suite 11000, Arlington, VA 
22209-2133.

    Dated: April 26, 2010.
Mitchell S. Bryman,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-10005 Filed 4-28-10; 8:45 am]
BILLING CODE 5001-06-P
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