TRICARE Prime Enrollment,
Disenrollment, and Primary Care Manager (PCM) Change
Extension without change of a currently approved collection
No
Regular
09/29/2025
Requested
Previously Approved
36 Months From Approved
09/30/2025
2,133,932
517,798
533,484
129,450
3,867,752
938,509
These collection instruments serve as
application for enrollment, disenrollment, and Primary Care Manager
(PCM) Change for the Department of Defense's TRICARE Prime program.
The information collected provides the necessary data to determine
beneficiary eligibility, complete enrollment, change beneficiary's
enrollment (new Primary Care Manager, enrolled region, add a
dependent, etc.), or dis-enroll the beneficiary.
US Code:
10
USC 1099 Name of Law: Health Care Enrollment System
The total respondent labor cost
has increased because of a general increase in enrollment action
requests to include the T5 contract transition where beneficiaries
were required to provide updated monthly payment set up information
to ensure enrollment fees could continue to be collected which may
be one contributing faction. Additionally, beneficiaries often
request consecutive changes over time (Ex: address/PCM/monthly
payment set up changes (expired credit card/debit card) which could
contribute to increased collections. Additionally, the cost of
first class postage has increased.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.