2018-13288. Submission for OMB Review; Comment Request  

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    Office of the Assistant Secretary of Defense for Health Affairs, DoD.


    30-Day information collection notice.


    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.


    Consideration will be given to all comments received by July 23, 2018.


    Comments and recommendations on the proposed information collection should be emailed to Ms. Cortney Higgins, DoD Desk Officer, at oira_submission@omb.eop.gov. Please identify the proposed information collection by DoD Desk Officer, Docket ID number, and title of the information collection.

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    Fred Licari, 571-372-0493, or whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil.

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    Title; Associated Form; and OMB Number: TRICARE Select Enrollment, Disenrollment, and Change Form; DD Form 3043; OMB Control Number 0720-0061.

    Type of Request: Extension.

    Number of Respondents: 99,300.

    Responses per Respondent: 1.

    Annual Responses: 99,300.

    Average Burden per Response: 15 minutes.

    Annual Burden Hours: 24,825.

    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.

    Frequency: On occasion.

    Respondent's Obligation: Voluntary.

    OMB Desk Officer: Ms. Cortney Higgins.

    You may also submit comments and recommendations, identified by Docket Start Printed Page 28841ID number and title, by the following method:

    Instructions: All submissions received must include the agency name, Docket ID 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.

    DOD Clearance Officer: Mr. Frederick Licari.

    Requests for copies of the information collection proposal should be sent to Mr. Licari at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil.

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    Dated: June 15, 2018.

    Aaron T. Siegel,

    Alternate OSD Federal Register, Liaison Officer, Department of Defense.

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    [FR Doc. 2018-13288 Filed 6-20-18; 8:45 am]

    BILLING CODE 5001-06-P

Document Information

Defense Department
30-Day information collection notice.
Document Number:
Consideration will be given to all comments received by July 23, 2018.
28840-28841 (2 pages)
Docket Numbers:
Docket ID DOD-2017-HA-0065
PDF File: