I 

109TH CONGRESS 

1ST SESSION H. R. 1478

To amend title 10, United States Code, to provide limited TRICARE program 

eligibility for members of the Ready Reserve of the Armed Forces, 

to provide financial support for continuation of health insurance for 

mobilized members of reserve components of the Armed Forces, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 5, 2005

Mr. TURNER (for himself, Mr. COOPER, Mr. SMITH of New Jersey, Mr. 

BROWN of Ohio, Mrs. MCCARTHY, Mr. MCGOVERN, Mr. PASTOR, and 

Mr. PETERSON of Minnesota) introduced the following bill; which was referred to the Committee on Armed Services, and in addition to the Committees on Energy and Commerce, Education and the Workforce, and 

Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL

To amend title 10, United States Code, to provide limited 

TRICARE program eligibility for members of the Ready 

Reserve of the Armed Forces, to provide financial support for continuation of health insurance for mobilized 

members of reserve components of the Armed Forces, 

and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘National Guard and 

3 Reserve Comprehensive Health Benefits Act of 2005’’. 

4 SEC. 2. TRICARE COVERAGE FOR MEMBERS OF THE READY 

5 RESERVE. 

6 (a) ELIGIBILITY.—Section 1076b of title 10, United 

7 States Code, is amended to read as follows: 

8 ‘‘§ 1076b. TRICARE program: coverage for members 

9 of the ready reserve 

10 ‘‘(a) ELIGIBILITY.—Members of the Selected Reserve 

11 of the Ready Reserve and members of the Individual 

12 Ready Reserve described in subsection 10144(b) of this 

13 title are eligible, subject to subsection (h)(1), to enroll in 

14 the following TRICARE program options: 

15 ‘‘(1) TRICARE Prime. 

16 ‘‘(2) TRICARE Standard. 

17 ‘‘(b) TYPES OF COVERAGE.—(1) A member eligible 

18 under subsection (a) may enroll for either of the following 

19 types of coverage: 

20 ‘‘(A) Self alone coverage. 

21 ‘‘(B) Self and family coverage. 

22 ‘‘(2) An enrollment by a member for self and family 

23 covers the member and the dependents of the member who 

24 are described in subparagraph (A), (D), or (I) of section 

25 1072(2) of this title. 
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1 ‘‘(c) OPEN ENROLLMENT PERIODS.—The Secretary 

2 of Defense shall provide for at least one open enrollment 

3 period each year. During an open enrollment period, a 

4 member eligible under subsection (a) may enroll in the 

5 TRICARE program or change or terminate an enrollment 

6 in the TRICARE program. 

7 ‘‘(d) SCOPE OF CARE.—(1) A member and the de8 pendents of a member enrolled in the TRICARE program 

9 under this section shall be entitled to the same benefits 

10 under this chapter as a member of the uniformed services 

11 on active duty or a dependent of such a member, respec12 tively. 

13 ‘‘(2) Section 1074(c) of this title shall apply with re14 spect to a member enrolled in the TRICARE program 

15 under this section. 

16 ‘‘(e) PREMIUMS.—(1) The Secretary of Defense shall 

17 charge premiums for coverage pursuant to enrollments 

18 under this section. The Secretary shall prescribe for each 

19 of the TRICARE program options referred to in sub20 section (a) a premium for self alone coverage and a pre21 mium for self and family coverage. 

22 ‘‘(2) The monthly amount of the premium in effect 

23 for a month for a type of coverage under this section shall 

24 be the amount equal to 28 percent of the total amount 
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1 determined by the Secretary on an appropriate actuarial 

2 basis as being reasonable for the coverage. 

3 ‘‘(3) The premiums payable by a member under this 

4 subsection may be deducted and withheld from basic pay 

5 payable to the member under section 204 of title 37 or 

6 from compensation payable to the member under section 

7 206 of such title. The Secretary shall prescribe the re8 quirements and procedures applicable to the payment of 

9 premiums by members not entitled to such basic pay or 

10 compensation. 

11 ‘‘(4) Amounts collected as premiums under this sub12 section shall be credited to the appropriation available for 

13 the Defense Health Program Account under section 1100 

14 of this title, shall be merged with sums in such Account 

15 that are available for the fiscal year in which collected, 

16 and shall be available under subsection (b) of such section 

17 for such fiscal year. 

18 ‘‘(f) OTHER CHARGES.—A person who receives 

19 health care pursuant to an enrollment in a TRICARE pro20 gram option under this section, including a member who 

21 receives such health care, shall be subject to the same 

22 deductibles, copayments, and other nonpremium charges 

23 for health care as apply under this chapter for health care 

24 provided under the same TRICARE program option to de-
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1 pendents described in subparagraph (A), (D), or (I) of sec2 tion 1072(2) of this title. 

3 ‘‘(g) TERMINATION OF ENROLLMENT.—(1) A mem4 ber enrolled in the TRICARE program under this section 

5 may terminate the enrollment only during an open enroll6 ment period provided under subsection (c), except as pro7 vided in subsection (h)(2). 

8 ‘‘(2) An enrollment of a member for self alone or for 

9 self and family under this section shall terminate on the 

10 first day of the first month beginning after the date on 

11 which the member ceases to be eligible under subsection 

12 (a). 

13 ‘‘(3) The enrollment of a member under this section 

14 may be terminated on the basis of failure to pay the pre15 mium charged the member under this section. 

16 ‘‘(h) RELATIONSHIP TO TRANSITION TRICARE COV17 ERAGE UPON SEPARATION FROM ACTIVE DUTY.—(1) A 

18 member may not enroll in the TRICARE program under 

19 this section while entitled to transitional health care under 

20 subsection (a) of section 1145 of this title or while author21 ized to receive health care under subsection (c) of such 

22 section. 

23 ‘‘(2) A member who enrolls in the TRICARE pro24 gram under this section within 90 days after the date of 

25 the termination of the member’s entitlement or eligibility 
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1 to receive health care under subsection (a) or (c) of section 

2 1145 of this title may terminate the enrollment at any 

3 time within one year after the date of the enrollment. 

4 ‘‘(i) REGULATIONS.—The Secretary of Defense, in 

5 consultation with the other administering Secretaries, 

6 shall prescribe regulations for the administration of this 

7 section.’’. 

8 (b) DEFINITIONS.—(1) Section 1072 of title 10, 

9 United States Code, is amended by adding at the end the 

10 following new paragraphs: 

11 ‘‘(10) The term ‘TRICARE Prime’ means the 

12 managed care option of the TRICARE program. 

13 ‘‘(11) The term ‘TRICARE Standard’ means 

14 the option of the TRICARE program that is also 

15 known as the Civilian Health and Medical Program 

16 of the Uniformed Services.’’. 

17 (2) Section 1097a(f) of such title is amended by 

18 striking ‘‘DEFINITIONS.—In this section:’’ and all that fol19 lows through ‘‘(2) The term’’ and inserting ‘‘CATCHMENT

20 AREA DEFINED.—In this section, the term’’. 

21 (c) PERIOD FOR IMPLEMENTATION.—Section 1076b 

22 of title 10, United States Code (as added by subsection 

23 (a)), shall apply with respect to months that begin on or 

24 after the date that is 180 days after the date of the enact25 ment of this Act. 
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1 (d) CONFORMING REPEALS.—

2 (1) Section 1076d of title 10, United States 

3 Code, is repealed, and the table of sections at the be4 ginning of chapter 55 of such title is amended by 

5 striking out the item relating to such section. 

6 (2) Subsection (b) of section 701 of the Ronald 

7 W. Reagan National Defense Authorization Act for 

8 Fiscal Year 2005 (Public Law 108–375; 118 Stat. 

9 1981) is repealed. 

10 SEC. 3. ALLOWANCE FOR CONTINUATION OF NON-TRICARE 

11 HEALTH BENEFITS COVERAGE FOR CERTAIN 

12 MOBILIZED RESERVES. 

13 (a) PAYMENT OF PREMIUMS.—(1) Chapter 55 of title 

14 10, United States Code, is amended by inserting after sec15 tion 1078a the following new section: 

16 ‘‘§ 1078b. Continuation of non-TRICARE health bene17 fits plan coverage for certain reserves 

18 called or ordered to active duty and their 

19 dependents 

20 ‘‘(a) PAYMENT OF PREMIUMS.—The Secretary con21 cerned shall pay the applicable premium to continue in 

22 force any qualified health benefits plan coverage for an 

23 eligible reserve component member for the benefits cov24 erage continuation period if timely elected by the member 
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1 in accordance with regulations prescribed under sub2 section (j). 

3 ‘‘(b) ELIGIBLE MEMBER.—A member of a reserve 

4 component is eligible for payment of the applicable pre5 mium for continuation of qualified health benefits plan 

6 coverage under subsection (a) while serving on active duty 

7 pursuant to a call or order issued under a provision of 

8 law referred to in section 101(a)(13)(B) of this title dur9 ing a war or national emergency declared by the President 

10 or Congress. 

11 ‘‘(c) QUALIFIED HEALTH BENEFITS PLAN COV12 ERAGE.—For the purposes of this section, health benefits 

13 plan coverage for a member called or ordered to active 

14 duty is qualified health benefits plan coverage if—

15 ‘‘(1) the coverage was in force on the date on 

16 which the Secretary notified the member that 

17 issuance of the call or order was pending or, if no 

18 such notification was provided, the date of the call 

19 or order; 

20 ‘‘(2) on such date, the coverage applied to the 

21 member and dependents of the member described in 

22 subparagraph (A), (D), or (I) of section 1072(2) of 

23 this title; and 

24 ‘‘(3) the coverage has not lapsed. 
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1 ‘‘(d) APPLICABLE PREMIUM.—The applicable pre2 mium payable under this section for continuation of health 

3 benefits plan coverage in the case of a member is the 

4 amount of the premium payable by the member for the 

5 coverage of the member and dependents. 

6 ‘‘(e) MAXIMUM AMOUNT.—The total amount that 

7 may be paid for the applicable premium of a health bene8 fits plan for a member under this section in a fiscal year 

9 may not exceed the amount determined by multiplying—

10 ‘‘(1) the sum of one plus the number of the 

11 member’s dependents covered by the health benefits 

12 plan, by 

13 ‘‘(2) the per capita cost of providing TRICARE 

14 coverage and benefits for dependents under this 

15 chapter for such fiscal year, as determined by the 

16 Secretary of Defense. 

17 ‘‘(f) BENEFITS COVERAGE CONTINUATION PE18 RIOD.—The benefits coverage continuation period under 

19 this section for qualified health benefits plan coverage in 

20 the case of a member called or ordered to active duty is 

21 the period that—

22 ‘‘(1) begins on the date of the call or order; and 

23 ‘‘(2) ends on the earlier of the date on which—

24 ‘‘(A) the member’s eligibility for transi25 tional health care under section 1145(a) of this 
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1 title terminates under paragraph (3) of such 

2 section; or 

3 ‘‘(B) the member elects to terminate the 

4 continued qualified health benefits plan cov5 erage of the dependents of the member. 

6 ‘‘(g) EXTENSION OF PERIOD OF COBRA COV7 ERAGE.—Notwithstanding any other provision of law—

8 ‘‘(1) any period of coverage under a COBRA 

9 continuation provision (as defined in section 

10 9832(d)(1) of the Internal Revenue Code of 1986) 

11 for a member under this section shall be deemed to 

12 be equal to the benefits coverage continuation period 

13 for such member under this section; and 

14 ‘‘(2) with respect to the election of any period 

15 of coverage under a COBRA continuation provision 

16 (as so defined), rules similar to the rules under sec17 tion 4980B(f)(5)(C) of such Code shall apply. 

18 ‘‘(h) NONDUPLICATION OF BENEFITS.—A dependent 

19 of a member who is eligible for benefits under qualified 

20 health benefits plan coverage paid on behalf of a member 

21 by the Secretary concerned under this section is not eligi22 ble for benefits under the TRICARE program during a 

23 period of the coverage for which so paid. 

24 ‘‘(i) REVOCABILITY OF ELECTION.—A member who 

25 makes an election under subsection (a) may revoke the 
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1 election. Upon such a revocation, the member’s depend2 ents shall become eligible for benefits under the 

3 TRICARE program as provided for under this chapter. 

4 ‘‘(j) REGULATIONS.—The Secretary of Defense shall 

5 prescribe regulations for carrying out this section. The 

6 regulations shall include such requirements for making an 

7 election of payment of applicable premiums as the Sec8 retary considers appropriate.’’. 

9 (2) The table of sections at the beginning of such 

10 chapter is amended by inserting after the item relating 

11 to section 1078a the following new item:

‘‘1078b. Continuation of non-TRICARE health benefits plan coverage for certain Reserves called or ordered to active duty and their dependents.’’.

12 (b) APPLICABILITY.—Section 1078b of title 10, 

13 United States Code (as added by subsection (a)), shall 

14 apply with respect to calls or orders of members of reserve 

15 components of the Armed Forces to active duty as de16 scribed in subsection (b) of such section, that are issued 

17 by the Secretary of a military department on or after the 

18 date of the enactment of this Act.

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