OFFICE OF THE ASSISTANT SECRETARY OF DEFENSE HEALTH AFFAIRS EASTCENTRETECH PARKWAY AURORA, CO

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1 OFFICE OF THE ASSISTANT SECRETARY OF DEFENSE HEALTH AFFAIRS EASTCENTRETECH PARKWAY AURORA, CO DEf"E E HE LTHAGENC HPOB CHANGE M DECEMBER 11, 2015 PUBLICATIONS SYSTEM CHANGE TRANSMITTAL FOR TRICARE OPERATIONS MANUAL (TOM}, FEBRUARY 2008 The TRICARE Management Activity has authorized the following addition(s)/revision(s). CHANGE TITLE: CALENDAR VEAR 2016 TRICARE RESERVE SELECT/TRICARE RETIRED RESERVE PREMIUM UPDATE CONREO: PAGE CHANGECSl: See page 2. SUMMARY OF CHANGECSl: This change updates the TRICARE Reserve Select (TRS)/TRICARE Retired Reserve (TRR) Premiums for EFFECTIVE DATE: January 1, IMPLEMENTATION DATE: January 1, Digitally signed by LQZQY A.JOSE LOzo_:A.JO~E.L ON. c-us, o-u.s. Government,. L ~~~~~0~~~~~~-~~~~~ Date: :03:20-07'00' John L. Arendale Section Chief, Health Plan Operations Branch (HPOB) Defense Health Agency (DH~) ATTACHMENT(S): DISTRIBUTION: 3 PAGES M WHEN PRESCRIBED ACTION HAS BEEN TAKEN, FILE THIS TRANSMITTAL WITH BASIC DOCUMENT.

2 CHANGE M DECEMBER 11, 2015 REMOVE PAGE(S) INSERT PAGE(S) CHAPTER 22 Addendum A, pages 1-3 Addendum A, pages 1-3 2

3 Chapter 22 TRICARE Operations Manual M, February 1, 2008 Reserve Component Health Coverage Plans Addendum A Figures FIGURE 22.A-1 CONTRACTOR CLOSURE LETTER (Addressee) (Address) (City, State Zip) RE: TRICARE Reserve Select Account No: Last Four Digits of Sponsor s SSN: Principal Due: $0.00 Dear : In our letter dated (Letter Date), you were asked to refund delinquent TRICARE Reserve Select premiums totaling (Amount Owed). TRICARE Management Activity has determined that no further action will be taken on this debt, we have adjusted your account to $0.00 and closed the collection action initiated against you. Please direct any questions you may have to my attention at the above address. Sincerely, (Signature) (Title) 1 C-91, January 10, 2013

4 TRICARE Operations Manual M, February 1, 2008 Chapter 22, Addendum A Figures FIGURE 22.A-2 TRICARE RESERVE SELECT (TRS) PREMIUMS EFFECTIVE FOR COVERAGE BEGINNING April 25, 2005 $ $ January 1, 2006 $ $ $ MONTHLY PREMIUM TYPE OF COVERAGE AUTHORITY COMMENTS $ $ $ TRS Tier 1 Member Only TRS Tier 2 Member Only TRS Tier 3 Member Only TRS Tier 1 Family TRS Tier 2 Family TRS Tier 3 Family Federal Register, Mar. 16, 2005 (70 FR 12801) HA Policy, Oct. 25, 2005 January 1, 2007 Same as above Same as above HA Policy, Oct. 26, 2006 Rates frozen by law. January 1, 2008 $ $ January 1, 2009 $ $ January 1, 2010 $ $ January 1, 2011 $ $ January 1, 2012 $ $ January 1, 2013 $ $ January 1, 2014 $ $ January 1, 2015 $ $ January 1, 2016 $ $ HA Policy, Oct. 17, 2007 Tiers 2 and 3 repealed. Rate freeze continued by law. HA Policy , Nov. 17, 2008 Rates derived from actual historical costs under TRS HA Policy, Oct. 15, 2009 HA Policy, Jul. 22, 2010 HA Policy , Aug. 24, 2011 HA Policy , Sep. 13, 2012 HA Memorandum , Aug. 22, 2013 HA Memorandum , Aug. 15, 2014 HA Memorandum , Aug. 21, C-160, December 11, 2015

5 TRICARE Operations Manual M, February 1, 2008 Chapter 22, Addendum A Figures FIGURE 22.A-3 TRICARE RETIRED RESERVE (TRR) PREMIUMS EFFECTIVE FOR COVERAGE BEGINNING October 1, 2010 $ $ January 1, 2011 $ $ 1, January 1, 2012 $ $ 1, January 1, 2013 $ $ January 1, 2014 $ $ January 1, 2015 $ $ January 1, 2016 $ $ MONTHLY PREMIUM TYPE OF COVERAGE AUTHORITY COMMENTS - END - Federal Register, Aug. 6, 2010 (75 FR 47453) Federal Register, Aug. 6, 2010 (75 FR 47453) HA Policy , Aug. 24, 2011 HA Policy , Sep. 13, 2012 HA Memorandum , Aug. 22, 2013 HA Memorandum , Aug. 15, 2014 HA Memorandum , Aug. 21, C-160, December 11, 2015

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