Federal Register / Vol. 83, No. 4 / Friday, January 5, 2018 / Notices 673 

8455–00–NSH–0001—Logo, BDU Coat and 

Shirt 

8455–00–NSH–0002—Logo, BDU Coat and 

Shirt 

Mandatory Source of Supply: Southeastern 

Kentucky Rehabilitation Industries, Inc., 

Corbin, KY 

Contracting Activity: Defense Logistics 

Agency Troop Support 

Amy B. Jensen, 

Director, Business Operations. 

[FR Doc. 2018–00010 Filed 1–4–18; 8:45 am] 

BILLING CODE 6353–01–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

[Docket ID: DOD–2017–HA–0065] 

Proposed Collection; Comment 

Request 

AGENCY: Office of the Assistant 

Secretary of Defense for Health Affairs, 

DoD. 

ACTION: 60-Day information collection 

notice. 

SUMMARY: In compliance with the 

Paperwork Reduction Act of 1995, the 

Office of the Assistant Secretary of 

Defense for Health Affairs announces a 

proposed public information collection 

and seeks public comment on the 

provisions thereof. Comments are 

invited on: Whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information shall have 

practical utility; the accuracy of the 

agency’s estimate of the burden of the 

proposed information collection; ways 

to enhance the quality, utility, and 

clarity of the information to be 

collected; and ways to minimize the 

burden of the information collection on 

respondents, including through the use 

of automated collection techniques or 

other forms of information technology. 

DATES: Consideration will be given to all 

comments received by March 6, 2018. 

ADDRESSES: You may submit comments, 

identified by docket number and title, 

by any of the following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: Department of Defense, Office 

of the Deputy Chief Management 

Officer, Directorate for Oversight and 

Compliance, Regulatory and Advisory 

Committee Division, 4800 Mark Center 

Drive, Mailbox #24, Suite 08D09B, 

Alexandria, VA 22350–1700. 

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. 

Any associated form(s) for this 

collection may be located within this 

same electronic docket and downloaded 

for review/testing. Follow the 

instructions at http://

www.regulations.gov for submitting 

comments. Please submit comments on 

any given form identified by docket 

number, form number, and title. 

FOR FURTHER INFORMATION CONTACT: To 

request more information on this 

proposed information collection or to 

obtain a copy of the proposal and 

associated collection instruments, 

please contact Defense Health Agency, 

TRICARE Health Plan (J–10), ATTN: 

Mark Ellis, 7700 Arlington Boulevard, 

Falls Church, VA 22042, or call the 

TRICARE Health Plan, 703–681–0039. 

SUPPLEMENTARY INFORMATION: 

Title; Associated Form; and OMB 

Number: TRICARE Select Enrollment, 

Disenrollment, and Change Form; DD 

Form 3043; OMB Control Number 0720– 

0061. 

Needs and Uses: The information 

collection requirement is necessary to 

obtain each non-active duty TRICARE 

beneficiary’s personal information 

needed to: (1) Complete his/her 

enrollment into the TRICARE Select 

health plan option, (2) dis-enroll a 

beneficiary, or (3) change a beneficiary’s 

enrollment information (e.g., address, 

add a dependent, report other health 

insurance). This information is required 

to ensure the beneficiary’s TRICARE 

benefits and claims are administered 

based on their TRICARE plan of choice. 

Without this new enrollment form, each 

non-active duty TRICARE beneficiary is 

automatically defaulted into direct care, 

limiting their health care options to 

military hospitals and clinics. These 

beneficiaries would have no TRICARE 

coverage when using the TRICARE 

network of providers for services not 

available at their local military hospital 

or clinic. 

Affected Public: Individuals or 

Households. 

Annual Burden Hours: 24,825. 

Number of Respondents: 99,300. 

Responses per Respondent: 1. 

Annual Responses: 99,300. 

Average Burden per Response: 15 

minutes. 

Frequency: On occasion. 

Respondents could be any non-active 

duty TRICARE beneficiary who is not 

eligible for Medicare. These 

beneficiaries have the option of 

enrolling into either the TRICARE Prime 

or TRICARE Select plan option starting 

January 1, 2018. Those choosing to 

enroll in TRICARE Select can do so by 

submitting the DD Form 3043, using the 

BWE portal, or calling their Regional 

Contractor. If they choose to use the DD 

Form 3043, they must complete the 

appropriate page(s) of the form and mail 

the form to their Regional Contractor. 

No other form is required to enroll, disenroll, or change an enrollment. 

Respondents can download the form 

from the DoD Forms Management 

Program website, or click on the link to 

the form on the TRICARE.mil website or 

their Regional Contractor’s website, or 

obtain a copy from their local military 

hospital or clinic. The mailing address 

and toll-free customer service number 

for their Regional Contractor are 

included on the DD Form 3043. If using 

either website option, the respondent 

can type in the information on the form 

prior to printing it or handwrite the 

information after printing the blank 

form. 

Dated: January 2, 2018. 

Aaron Siegel, 

Alternate OSD Federal Register Liaison 

Officer, Department of Defense. 

[FR Doc. 2018–00007 Filed 1–4–18; 8:45 am] 

BILLING CODE 5001–06–P 

DEPARTMENT OF DEFENSE 

Office of the Secretary 

TRICARE; Notice of TRICARE Prime 

and TRICARE Select Plan Information 

for Calendar Year 2018 

AGENCY: Office of the Secretary of 

Defense, Department of Defense. 

ACTION: TRICARE Prime and TRICARE 

Select Plan Information for Calendar 

Year 2018. 

SUMMARY: This notice provides a notice 

of TRICARE Prime and TRICARE Plan 

Information for Calendar Year 2018. 

DATES: TRICARE health plan 

information in this notice is valid for 

services during calendar year 2018 

(January 1, 2018–December 31, 2018). 

ADDRESSES: Defense Health Agency, 

TRICARE Health Plan, 7700 Arlington 

Boulevard, Suite 5101, Falls Church, 

Virginia 22042–5101. 

FOR FURTHER INFORMATION CONTACT: Mr. 

Mark A. Ellis, (703) 681–0039. 

SUPPLEMENTARY INFORMATION: An 

interim final rule published in the 


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