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[Federal Register Volume 86, Number 120 (Friday, June 25, 2021)]
[Notices]
[Pages 33692-33693]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-13626]

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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DoD-2021-HA-0050]

Proposed Collection; Comment Request

AGENCY: The Office of the Assistant Secretary of Defense for Health 
Affairs, Department of Defense (DoD).

ACTION: Information collection notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Defense Health Agency 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

[[Page 33693]]

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 August 
24, 2021.

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: The DoD cannot receive written comments at this time due to 
the COVID-19 pandemic. Comments should be sent electronically to the 
docket listed above.
    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.

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 write to the Defense Health 
Agency, ATTN: Ms. Zelly Zim, 8111 Gatehouse Road, 229D, Falls Church, 
VA 22042 or call 571-232-1551.

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.

    Dated: June 16, 2021.
Aaron T. Siegel,
Alternate OSD Federal Register, Liaison Officer, Department of Defense.
[FR Doc. 2021-13626 Filed 6-24-21; 8:45 am]
BILLING CODE 5001-06-P
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