Federal Register / Vol. 79, No. 166 / Wednesday, August 27, 2014 / Proposed Rules 51127 

meets the criteria of paragraph (b)(1) 

through (3) of this section. 

(1) The organization opposes 

providing coverage for some or all of 

any contraceptive items or services 

required to be covered under 

§ 147.130(a)(1)(iv) on account of 

religious objections. 

(2)(i) The organization is organized 

and operates as a nonprofit entity and 

holds itself out as a religious 

organization; or 

(ii) The organization is organized and 

operates as a closely held for-profit 

entity, as defined in paragraph (b)(4) of 

this section, and the entity’s objection to 

covering some or all of the contraceptive 

services on account of its owners’ 

sincerely held religious beliefs is made 

in accordance with the organization’s 

applicable rules of governance, 

consistent with state law. 

(3) The organization must self-certify 

in the form and manner specified by the 

Secretary or provide notice to the 

Secretary of Health and Human Services 

as described in paragraph (c) of this 

section. The organization must make 

such self-certification or notice available 

for examination upon request by the 

first day of the first plan year to which 

the accommodation in paragraph (c) of 

this section applies. The selfcertification or notice must be executed 

by a person authorized to make the 

certification on behalf of the 

organization, and must be maintained in 

a manner consistent with the record 

retention requirements under section 

107 of ERISA. 

(4) [Reserved] 

* * * * * 

(f) Application to student health 

insurance coverage. The provisions of 

this section apply to student health 

insurance coverage arranged by an 

eligible organization that is an 

institution of higher education as 

defined in 20 U.S.C. 1002 in a manner 

comparable to that in which they apply 

to group health insurance coverage 

provided in connection with a group 

health plan established or maintained 

by an eligible organization that is an 

employer. In applying this section in the 

case of student health insurance 

coverage, a reference to ‘‘plan 

participants and beneficiaries’’ is a 

reference to student enrollees and their 

covered dependents. 

[FR Doc. 2014–20254 Filed 8–22–14; 3:30 pm] 

BILLING CODE 4830–01–P; 4510–029–P; 4120–01–P; 

6325–64 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

32 CFR Part 199 

[DOD–2006–HA–0207] 

RIN 0720–AB15 

Civilian Health and Medical Program of 

the Uniformed Services (CHAMPUS); 

TRICARE Reserve Select; TRICARE 

Dental Program; Early Eligibility for 

TRICARE for Certain Reserve 

Component Members 

AGENCY: Office of the Secretary, DoD. 

ACTION: Proposed rule. 

SUMMARY: TRICARE Reserve Select 

(TRS) is a premium-based TRICARE 

health plan available for purchase 

worldwide by qualified members of the 

Ready Reserve and by qualified 

survivors of TRS members. TRICARE 

Dental Program (TDP) is a premiumbased TRICARE dental plan available 

for purchase worldwide by qualified 

Service members. This proposed rule 

revises requirements and procedures for 

the TRS program to specify the 

appropriate actuarial basis for 

calculating premiums in addition to 

other minor clarifying administrative 

changes. For a member who is 

involuntarily separated from the 

Selected Reserve under other than 

adverse conditions this proposed rule 

provides a time-limited exception that 

allows TRS coverage in effect to 

continue for up to 180 days after the 

date on which the member is separated 

from the Selected Reserve and TDP 

coverage in effect to continue for no less 

than 180 days after the separation date. 

It also expands early TRICARE 

eligibility for certain Reserve 

Component members from a maximum 

of 90 days to a maximum of 180 days 

prior to activation in support of a 

contingency for more than 30 days. 

DATES: Submit comments on or before 

October 27, 2014. 

ADDRESSES: You may submit comments, 

identified by docket number or 

Regulation Identifier Number (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, 4800 Mark Center Drive, 

East Tower, Suite 02G09, Alexandria, 

VA 22350–3100. 

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, Defense Health Agency, 

TRICARE Health Plan Division, 

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 

This proposed rule addresses 

provisions of the National Defense 

Authorization Act for Fiscal Year 2009 

(NDAA–09) (Pub. L. 110–417), the 

National Defense Authorization Act for 

Fiscal Year 2010 (NDAA–10) (Pub. L. 

111–84), and the National Defense 

Authorization Act for Fiscal Year 2013 

(NDAA–13) (Pub. L. 112–239). First, 

section 704 of NDAA–09 specifies that 

the appropriate actuarial basis for 

calculating premiums for TRS shall 

utilize the actual cost of providing 

benefits to members and their 

dependents during preceding calendar 

years. Second, section 702 of NDAA–10 

expands early eligibility for Reserve 

Component members issued delayedeffective-date active duty orders from a 

maximum of 90 days to a maximum of 

180 days prior to activation in support 

of a contingency for more than 30 days. 

Third, for a member who is 

involuntarily separated from the 

Selected Reserve under other than 

adverse conditions as characterized by 

the Secretary concerned, section 701 of 

NDAA–13 provides a time-limited 

exception that allows TRS coverage 

already in effect at time of separation to 

continue for up to 180 days after the 

date on which the member is separated 

from the Selected Reserve and TDP 

coverage already in effect at time of 

separation to continue for no less than 

180 days after the separation date. This 

exception expires December 31, 2018. 

Finally, additional administrative 

clarifications have been made to 32 CFR 

199.24, which implements TRS. 

II. Provisions of the Rule Regarding 

Early TRICARE Eligibility 

Section 199.3(b)(5) implements 

section 702 of NDAA–10, which 

specifies that, Reserve Component 

members issued delayed-effective-date 

orders for service in support of a 

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51128 Federal Register / Vol. 79, No. 166 / Wednesday, August 27, 2014 / Proposed Rules 

contingency operation, and their family 

members, are eligible for TRICARE on 

the date the orders are issued, up to a 

maximum of 180 days prior to the date 

on which the period of active duty of 

more than 30 consecutive days is to 

begin. Previously, members and their 

family members could become eligible 

for TRICARE up to a maximum of 90 

days prior to the date on which the 

period of active duty in support of a 

contingency operation of more than 30 

consecutive days is to begin. 

III. Provisions of the Rule Regarding 

the TRICARE Dental Program 

So that the existing provisions of 

§ 199.13(c)(3)(ii)(E)(2) would not be 

confused with the new paragraph 

described below, we propose to clarify 

that the continued coverage described in 

this paragraph is actually survivor 

coverage. We also propose to reinsert 

the provision that the government will 

pay both the government and the 

beneficiary’s portion of the premium 

share during the three-year period of 

continued survivor enrollment, which 

was inadvertently deleted by a previous 

amendment to the regulation. 

We propose to add new 

§ 199.13(c)(3)(ii)(E)(5) that implements 

the provisions in section 701 of NDAA– 

13 concerning TDP. A time-limited 

exception is added to the general rule 

that TDP coverage shall terminate for 

members who no longer qualify for TDP. 

This exception specifies that if a 

member is involuntarily separated from 

the Selected Reserve under other than 

adverse conditions, as characterized by 

the Secretary concerned, and TDP 

coverage was in effect for the member 

and/or the family on the last day of his 

or her membership in the Selected 

Reserve, the TDP coverage that was in 

effect, whether member coverage and/or 

family coverage, may terminate no 

earlier than 180 days after the date on 

which the member is separated from the 

Selected Reserve. This exception 

expires December 31, 2018. 

IV. Provisions of the Rule Regarding the 

TRICARE Reserve Select Program 

Many of our proposed clarifications 

update the rules for TRS (§ 199.24) and, 

as appropriate, bring the rules in closer 

alignment and sequencing with the very 

similar TRICARE Retired Reserve 

program (§ 199.25). 

A. Establishment of the TRICARE 

Reserve Select Program (§ 199.24(a)). We 

propose to remove the existing 

terminology at § 199.24(a)(4) and to 

redesignate § 199.24(a)(5) as 

§ 199.24(a)(4). We propose to clarify that 

certain special programs established in 

32 CFR part 199 are not available to 

members covered under TRS 

(§ 199.24(a)(4)(i)(B)). 

We propose to clarify the wording for 

submitting an initial payment of the 

appropriate premium along with the 

request to purchase coverage 

(§ 199.24(a)(4)(iii)) and to make it 

consistent throughout this section. We 

propose to clarify that 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 active duty service 

members’ dependents who are not 

enrolled in TRICARE Prime 

(§ 199.24(a)(4)(iv)). 

B. Qualifications for TRICARE 

Reserve Select coverage (§ 199.24(b)). 

We propose to redesignate § 199.24(c) as 

§ 199.24(b) so that it precedes the 

section on TRICARE Reserve Select 

premiums for clarity and maintains 

parallel sequencing with § 199.25. 

Section 10144(b) of title 10, U.S.C. 

provides that the Secretary concerned 

may designate a category of members 

within the Individual Ready Reserve 

(IRR) of each Reserve Component who 

are subject to being ordered to active 

duty involuntarily in accordance with 

section 12304 of title 10, U.S.C. We 

propose to clarify that since a member 

of the IRR who has volunteered to serve 

in such mobilization category is eligible 

for benefits (other than pay and training) 

as are normally available to members of 

the Selected Reserve, these members 

may also qualify for TRS 

(§ 199.24(b)(1)(i)). 

We propose to clarify the exclusion 

involving the Federal Employees Health 

Benefits (FEHB) program. Section 

199.24(b)(1)(ii) specifies that an 

otherwise qualified member of the 

Ready Reserve qualifies to purchase 

TRS coverage if the member is not 

enrolled in, or eligible to enroll in, a 

health benefits plan under chapter 89 of 

title 5, U.S.C. That statute has been 

implemented under part 890 of title 5, 

CFR as the ‘‘Federal Employees Health 

Benefits’’ program. For purposes of the 

FEHB program, the terms ‘‘enrolled,’’ 

‘‘enroll’’ and ‘‘enrollee’’ are defined in 

§ 890.101 of title 5, CFR. We propose to 

clarify that the member (or certain 

involuntarily separated former member) 

no longer qualifies for TRS coverage 

when the member has been eligible for 

active coverage in a health benefits plan 

under the FEHB program for more than 

60 days (§ 199.24(b)(1)(ii)). This affords 

the member sufficient time to make 

arrangements for health coverage other 

than TRS and avoid any days without 

having health coverage being in force. 

We propose to clarify that 

qualification for TRS survivor coverage 

applies regardless of type of coverage in 

effect on the day of the TRS member’s 

death (§ 199.24(b)(2)). 

C. TRICARE Reserve Select premiums 

(§ 199.24(c)). We propose to redesignate 

§ 199.24(b) as § 199.24(c) so that it 

follows the section on Qualifications for 

TRICARE Reserve Select coverage for 

clarity purposes and maintains 

consistent sequencing with § 199.25. We 

also propose to clarify that the Director, 

Healthcare Operations in the Defense 

Health Agency may establish 

procedures for administrative 

implementation related to premiums 

(§ 199.24(c)). 

Section 199.24(c)(1) implements 

section 704 of NDAA–09, which 

requires that monthly premiums be 

determined by utilizing the actual 

reported cost of providing benefits to 

TRS members and their dependents 

during preceding calendar years. 

Section 704 of NDAA–09 specified that 

actual TRS cost data from calendar years 

2006 and 2007 be utilized in the 

determination of premium rates for 

calendar year 2009. This established 

pattern has been followed to determine 

premium rates for all calendar years 

starting with 2009 (§ 199.24(c)(1)). 

Further, we propose to amend 

§ 199.24(c) by deleting all former 

provisions involving the relationship 

between premium rates for TRS and 

premium rates for the Blue Cross and 

Blue Shield Standard Service Benefit 

Plan under the Federal Employees 

Health Benefits program. 

D. Procedures (§ 199.24(d)). We 

propose to clarify that the Director, 

Healthcare Operations in the Defense 

Health Agency may establish 

procedures for TRS (§ 199.24(d)). 

We propose to clarify that either 

reserve members or survivors qualified 

under § 199.24(b) may follow applicable 

procedures throughout this section 

regarding TRS coverage. We propose to 

clarify the rule about immediate family 

members who may be included in 

family coverage under TRS 

(§ 199.24(d)(1)), which is further 

supported by the proposed definition 

for immediate family member included 

in § 199.24(g). 

We propose to clarify continuation 

coverage by removing the previous 

requirement that the member had to be 

the sponsor of the other TRICARE 

coverage in order to qualify for 

continuation coverage (§ 199.24(d)(1)(i)). 

In circumstances when the spouse of the 

Reserve Component member is the 

sponsor for purposes of the other 

TRICARE coverage, it would be clear 

that the qualified member would be able 

to purchase TRS coverage with an 

effective date immediately following the 

date of termination of coverage under 

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Federal Register / Vol. 79, No. 166 / Wednesday, August 27, 2014 / Proposed Rules 51129 

another TRICARE program regardless 

whether it was the Reserve Component 

member or the spouse who was the 

sponsor of the other TRICARE coverage. 

We propose rules to implement the 

provisions in section 701 of NDAA–13 

concerning TRS coverage 

(§ 199.24(d)(3)(i)). Similar to the TDP, 

this provision would apply to members 

involuntarily separated from the 

Selected Reserve if, and only if, the 

member was covered by TRS on the last 

day of his or her membership in the 

Selected Reserve. However, the 

termination date of TRS is characterized 

slightly different from the TCP 

provision because TRS may terminate 

up to 180 days after the date on which 

the member is separated from the 

Selected Reserve. This delayed 

termination exception applies regardless 

of type of TRS coverage actually in 

effect at the time. This exception expires 

December 31, 2018. 

We propose to clarify the rule that 

procedures may be established for TRS 

coverage to be suspended for up to one 

year followed by final termination for 

members or qualified survivors if they 

fail to make premium payments in 

accordance with established procedures 

or otherwise if they request suspension/ 

termination of coverage (§ 199.24(d)(3)). 

Suspension/termination of coverage for 

the TRS member/survivor will result in 

suspension/termination of coverage for 

the member’s/survivor’s family 

members in TRS, except as described in 

§ 199.24 (d)(1)(iv). We also propose to 

clarify that procedures may be 

established for the suspension to be 

lifted upon request before final 

termination is applied. 

E. Preemption of State laws 

(§ 199.24(e)). We propose to remove the 

previous § 199.24(e) Reserved and 

redesignate § 199.24(f) as § 199.24(e). No 

other changes are proposed this section. 

F. Administration (§ 199.25(f)). We 

propose to redesignate § 199.24(g) as 

§ 199.24(f). We propose to clarify this 

provision by removing the phrase, 

‘‘based on extraordinary circumstances’’ 

and propose to clarify that the Director, 

Healthcare Operations in the Defense 

Health Agency has authority to perform 

this activity. 

G. Terminology (§ 199.25(g)). We 

propose to add this section and to 

remove the terminology under 

§ 199.25(a)(4). Immediate family 

member, and other terms applicable to 

the TRS are listed. 

—Coverage 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 means 

spouse (except former spouse) as 

defined in § 199.3(b)(2)(i) or child as 

defined in § 199.3(b)(2)(ii). 

—Qualified member means a member 

who has satisfied all the criteria that 

must be met before the member is 

authorized for TRS coverage. 

—Qualified survivor means an 

immediate family member who has 

satisfied all the criteria that must be 

met before the survivor is authorized 

for TRS coverage. 

V. Costs 

Fiscal year 2014 through 2019 costs 

are anticipated to be $7,735,728.00: 

Fiscal year Government cost 

2014 .................................. $1,296,884 

2015 .................................. 1,373,929 

2016 .................................. 1,455,633 

2017 .................................. 1,542,277 

2018 .................................. 1,634,096 

2019 .................................. 432,909 

Total FY14–FY19 .......... 7,735,728 

VI. Regulatory Procedures 

Executive Orders 12866 and 13563 

require 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 proposed rule is not 

subject to any of these requirements 

because it will 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 proposed rule under Executive 

Order 13132 and it does not have 

policies that have federalism 

implications that will 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 a 

proposed rule with comment period. 

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, Military personnel. 

Accordingly, 32 CFR part 199 is 

proposed to be 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. Amend § 199.3 by revising 

paragraph (b)(5)(iii)(B) to read as 

follows: 

§ 199.3 Eligibility. 

* * * * * 

(b) * * * 

(5) * * * 

(iii) * * * 

(B) 180 days before the date on which 

the period of active duty is to begin. 

* * * * * 

■ 3. Amend § 199.13 by revising 

paragraph (c)(3)(ii)(E)(2) and adding 

paragraph (c)(3)(ii)(E)(5) to read as 

follows: 

§ 199.13 TRICARE Dental Program. 

* * * * * 

(c) * * * 

(3) * * * 

(ii) * * * 

(E) * * * 

(2) Survivor eligibility. Eligible 

dependents of active duty members who 

die while on active duty for a period of 

more than 30 days and eligible 

dependents of members of the Ready 

Reserve (i.e., Selected Reserve or 

Individual Ready Reserve, as specified 

in 10 U.S.C. 10143 and 10144(b) 

respectively) who die, shall be eligible 

for survivor enrollment in the TDP. 

During the period of survivor 

enrollment, the government will pay 

both the government and the eligible 

dependent’s portion of the premium 

share. This survivor enrollment shall be 

up to (3) three years from the date of the 

member’s death, except that, in the case 

of a dependent of the deceased who is 

described in 10 U.S.C. 1072(2)(D) or (I), 

the period of survivor enrollment shall 

be the longer of the following periods 

beginning on the date of the member’s 

death: 

* * * * * 

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51130 Federal Register / Vol. 79, No. 166 / Wednesday, August 27, 2014 / Proposed Rules 

(5) TRICARE Dental Program coverage 

shall terminate for members who no 

longer qualify for the TRICARE Dental 

Program as specified in paragraph (c)(2) 

of this section, with one exception. If a 

member is involuntarily separated from 

the Selected Reserve under other than 

adverse conditions, as characterized by 

the Secretary concerned, and TRICARE 

Dental Program coverage is in effect for 

the member and/or the family on the 

last day of his or her membership in the 

Selected Reserve; then the TRICARE 

Dental Program coverage that was 

actually in effect may terminate no 

earlier than 180 days after the date on 

which the member is separated from the 

Selected Reserve. This exception 

expires December 31, 2018. 

* * * * * 

■ 4. Amend § 199.24 as follows. 

■ a. Remove paragraph (a)(4). 

■ b. Redesignate paragraph (a)(5) as 

paragraph (a)(4). 

■ c. Revise newly redesignated 

paragraphs (a)(4)(i)(B), (a)(4)(iii), and 

(a)(4)(iv). 

■ d. Redesignate paragraphs (b) and (c) 

as paragraphs (c) and (b), respectively. 

■ e. Revise newly redesignated 

paragraphs (b) and (c). 

■ f. Revise paragraph (d). 

■ g. Remove paragraph (e). 

■ h. Redesignate paragraphs (f) and (g) 

as paragraphs (e) and (f), respectively. 

■ i. Revise newly redesignated 

paragraph (f). 

■ j. Add paragraph (g). 

The revisions and additions read as 

follows: 

§ 199.24 TRICARE Reserve Select. 

* * * * * 

(a) * * * 

(4) * * * 

(i) * * * 

(B) Certain special programs 

established in 32 CFR part 199 are not 

available to members covered under 

TRICARE Reserve Select. These include 

the Extended Care Health Option 

(§ 199.5), the Special Supplemental 

Food Program (see § 199.23), and the 

Supplemental Health Care Program 

(§ 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 

Dental Program (§ 199.13) is 

independent of this program and is 

otherwise available to all members of 

the Selected Reserve and their eligible 

family members whether or not they 

purchase TRICARE Reserve Select 

coverage. The Continued Health Care 

Benefits Program (§ 199.13) is also 

independent of this program and is 

otherwise available to all members who 

qualify. 

* * * * * 

(iii) Procedures. Under TRICARE 

Reserve Select, Reserve Component 

members 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. Rules and 

procedures for purchasing coverage and 

paying applicable premiums are 

prescribed in this section. 

(iv) Benefits. When their coverage 

becomes effective, TRICARE Reserve 

Select beneficiaries receive the 

TRICARE Standard (and Extra) benefit 

including access to military treatment 

facility services and pharmacies, as 

described in § 199.17. TRICARE Reserve 

Select coverage features the deductible 

and cost share provisions of the 

TRICARE Standard (and Extra) plan 

applicable to active duty family 

members for both the member and the 

member’s covered family members 

(paragraph (a)(4)(iv) of this section). 

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 

active duty service members’ 

dependents who are not enrolled in 

TRICARE Prime as described in 

§ 199.17(d)(1)(i)(D). 

(b) Qualifications for TRICARE 

Reserve Select coverage—(1) Ready 

Reserve member. A Ready Reserve 

member qualifies to purchase TRICARE 

Reserve Select coverage if the Service 

member meets both the following 

criteria: 

(i) Is a member of the Selected 

Reserve of the Ready Reserve of the 

Armed Forces, or a member of the 

Individual Ready Reserve of the Armed 

Forces who has volunteered to be 

ordered to active duty pursuant to the 

provisions of 10 U.S.C. 12304 in 

accordance with section 10 U.S.C. 

10144(b); and 

(ii) Is not enrolled in, or eligible to 

enroll in, a health benefits plan under 

5 U.S.C. chapter 89. That statute has 

been implemented under 5 CFR part 890 

as the Federal Employees Health 

Benefits (FEHB) program. For purposes 

of the FEHB program, the terms 

‘‘enrolled,’’ ‘‘enroll’’ and ‘‘enrollee’’ are 

defined in 5 CFR 890.101. Further, the 

member (or certain former member 

involuntarily separated) no longer 

qualifies for TRICARE Reserve Select 

when the member (or former member) 

has been eligible for coverage to be 

effective in a health benefits plan under 

the FEHB program for more than 60 

days. 

(2) TRICARE Reserve Select survivor. 

If a qualified Service member dies while 

in a period of TRICARE Reserve Select 

coverage, the immediate family 

member(s) of such member is qualified 

to purchase new or continue existing 

TRICARE Reserve Select coverage for up 

to six months beyond the date of the 

member’s death as long as they meet the 

definition of immediate family members 

as specified in paragraph (g)(2) of this 

section. This applies regardless of type 

of coverage in effect on the day of the 

TRICARE Reserve Select member’s 

death. 

(c) TRICARE Reserve Select 

premiums. Members are charged 

premiums for coverage under TRICARE 

Reserve Select that represent 28 percent 

of the total annual premium amount 

that the Director, Defense Health 

Agency determines on an appropriate 

actuarial basis as being appropriate for 

coverage under the TRICARE Standard 

(and Extra) benefit for the TRICARE 

Reserve Select eligible population. 

Premiums are to be paid monthly, 

except as otherwise provided through 

administrative implementation, 

pursuant to procedures established by 

the Director, Healthcare Operations in 

the Defense Health Agency. 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. 

TRICARE Reserve Select monthly 

premium rates shall be established and 

updated annually on a calendar year 

basis for each of the two types of 

coverage, member-only and memberand-family as described in paragraph 

(d)(1) of this section. Starting with 

calendar year 2009, the appropriate 

actuarial basis for purposes of 

§ 199.24(c) shall be determined for each 

calendar year by utilizing the actual 

reported cost of providing benefits 

under this section to members and their 

dependents during the calendar years 

preceding such calendar year. Reported 

actual TRS cost data from calendar years 

2006 and 2007 was used to determine 

premium rates for calendar year 2009. 

This established pattern will be 

followed to determine premium rates for 

all calendar years subsequent to 2009. 

(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 TRICARE Reserve Select. 

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(3) Survivor premiums. A surviving 

family member of a Reserve Component 

service member who qualified for 

TRICARE Reserve Select coverage as 

described in paragraph (b)(2) of this 

section will pay premium rates as 

follows. The premium amount shall be 

at the member-only rate if there is only 

one surviving family member to be 

covered by TRICARE Reserve Select and 

at the member and family rate if there 

are two or more survivors to be covered. 

(d) Procedures. The Director, 

Healthcare Operations in the Defense 

Health Agency, 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 a qualified member 

as specified in paragraph (g)(2) of this 

section may be included in such family 

coverage. To purchase either type of 

TRICARE Reserve Select coverage for 

effective dates of coverage described 

below, members and survivors qualified 

under either paragraph (b)(1) or (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 Reserve Select 

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 Reserve Select 

coverage on the occasion of a qualifying 

life event that changes the immediate 

family composition (e.g., birth, 

adoption, divorce, etc.) that is eligible 

for coverage under TRICARE Reserve 

Select. The effective date for TRICARE 

Reserve Select 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 to 

purchase TRICARE Reserve Select 

coverage at any time. The effective date 

of coverage will coincide with the first 

day of a month. 

(iv) Survivor coverage under TRICARE 

Reserve Select. Procedures may be 

established for a surviving family 

member of a Reserve Component service 

member who qualified for TRICARE 

Reserve Select coverage as described in 

paragraph (b)(2) of this section to 

purchase new TRICARE Reserve Select 

coverage or continue existing TRICARE 

Reserve Select coverage for up to six 

months beyond the date of the member’s 

death. The effective date of coverage 

will be the day following the date of the 

member’s death. 

(2) Changing type of coverage. 

Procedures may be established for 

TRICARE Reserve Select members 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) Suspension and termination. 

Suspension/termination of coverage for 

the TRS member/survivor will result in 

suspension/termination of coverage for 

the member’s/survivor’s family 

members in TRICARE Reserve Select, 

except as described in paragraph 

(d)(1)(iv) of this section. Procedures may 

be established for coverage to be 

suspended or terminated as follows. 

(i) Coverage shall terminate when 

members or survivors no longer qualify 

for TRICARE Reserve Select as specified 

in paragraph (b) of this section, with one 

exception. If a member is involuntarily 

separated from the Selected Reserve 

under other than adverse conditions, as 

characterized by the Secretary 

concerned, and is covered by TRICARE 

Reserve Select on the last day of his or 

her membership in the Selected 

Reserve, then TRICARE Reserve Select 

coverage may terminate up to 180 days 

after the date on which the member was 

separated from the Selected Reserve. 

This applies regardless of type of 

coverage. This exception expires 

December 31, 2018. 

(ii) Coverage may terminate for 

members, former members, and 

survivors who gain coverage under 

another TRICARE program. 

(iii) Coverage may be suspended and 

finally terminated for members/

survivors who fail to make premium 

payments in accordance with 

established procedures. 

(iv) Coverage may be suspended and 

finally terminated for members/

survivors upon request at any time by 

submitting a completed request in the 

appropriate format in accordance with 

established procedures. 

(v) Under paragraph (d)(3)(iii) or (iv) 

of this section, TRICARE Reserve Select 

coverage may first be suspended for a 

period of up to one year followed by 

final termination. Procedures may be 

established for the suspension to be 

lifted upon request before final 

termination is applied. 

(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 Reserve Select 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. 

* * * * * 

(f) Administration. The Director, 

Healthcare Operations in the Defense 

Health Agency may establish other rules 

and procedures for the effective 

administration of TRICARE Reserve 

Select, and may authorize exceptions to 

requirements of this section, if 

permitted by law. 

(g) Terminology. The following terms 

are applicable to the TRICARE Reserve 

Select program. 

(1) Coverage. This term means the 

medical benefits covered under the 

TRICARE Standard or Extra programs as 

further outlined in other sections of 32 

CFR part 199 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 § 199.3(b)(2)(i), or 

child as defined in § 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 TRS 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 TRS coverage. 

Dated: August 18, 2014. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2014–19904 Filed 8–26–14; 8:45 am] 

BILLING CODE 5001–06–P 

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