99-25761. Submission for OMB Review; Comment Request
[Federal Register Volume 64, Number 192 (Tuesday, October 5, 1999)]
[Notices]
[Pages 54005-54006]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-25761]
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DEPARTMENT OF DEFENSE
Office of the Secretary
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).
Title and OMB Number: TRICARE Enrollment Application Form; OMB
Number 0720-0008.
Type of Request: Reinstatement.
Number of Respondents: 575,210.
Responses per Respondent: 1.
Annual Responses: 575,210.
Average Burden per Response: 15 minutes.
Annual Burden Hours: 143,802.
Needs and Uses: The form serves as an application form for
enrollment in the TRICARE Health Care Delivery Program established in
accordance with 10 U.S.C. 1099. The Department of Defense established
TRICARE to povide for a more cost effective program for the delivery of
health care services and to
[[Page 54006]]
improve the quality and access to health care services. The information
collected provides the private Third Party Administrator, contracted to
provide administrative support services, with necessary data to
determine beneficiary eligibility, other health insurance liability,
premium payment, and to identify the selection of a health care option.
Affected Public: Individuals or Households.
Frequency: On occasion.
Respondent's Obligation: Required to Obtain or Retain Benefits.
OMB Desk Officer: Ms. Allison Eydt.
Written comments and recommendations on the proposed information
collection should be sent to Ms. Eydt at the Office of Management and
Budget, Desk Officer for DoD Health Affairs, Room 10235, New Executive
Office Building, Washington, DC 20503.
DoD Clearance Officer: Mr. Robert Cushing.
Written requests for copies of the information collection proposal
should be send to Mr. Cushing, WHS/DIOR, 1215 Jefferson Davis Highway,
Suite 1204, Arlington, VA 22202-4302.
Dated: September 28, 1999.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 99-25761 Filed 10-4-99; 8:45 am]
BILLING CODE 5001-16-M
Document Information
- Published:
- 10/05/1999
- Department:
- Defense Department
- Entry Type:
- Notice
- Action:
- Notice.
- Document Number:
- 99-25761
- Pages:
- 54005-54006 (2 pages)
- PDF File:
-
99-25761.pdf