Changes to TRICARE Reserve Select (TRS), Part 1 of 2 (Tier 1)

1.  PURPOSE.  TO IMPLEMENT RECENT ENHANCEMENTS AND
PROMULGATE UPDATED GUIDANCE, BASED ON REFS A AND B, TO THE TRS 
PROGRAM.  THIS IS A TWO-PART MARADMIN.  INTRODUCTION OF NEW TRS
PROGRAMS BASED ON REF C WILL BE PROMULGATED VIA FUTURE MARADMIN.
ADDITIONALLY, THIS MARADMIN UPDATES PARAGRAPHS 3D THROUGH 3J OF
REF D.  MARINE FORCES RESERVE (MARFORRES) COMMANDERS MUST ENSURE
THAT UNIT TRS REPRESENTATIVES (REPS) THOROUGHLY FAMILIARIZE
THEMSELVES WITH THE NEW ENHANCEMENTS TO THE TRS PROGRAM.
2.  BACKGROUND.
A.  ORIGINALLY ESTABLISHED UNDER NDAA FY05, TRS IS A PREMIUM-BASED
TRICARE HEALTH PLAN FOR SELECTED RESERVE MEMBERS.  TRS OFFERS
RESERVE MEMBERS TRICARE STANDARD COVERAGE WITH THE SAME
DEDUCTIBLES AND COST SHARES THAT APPLY TO ACTIVE DUTY MEMBERS.
B.  NDAA FY06 INTRODUCED A THREE-TIERED BENEFIT WITH SEPARATE
QUALIFICATION REQUIREMENTS AND PREMIUM RATES FOR EACH TIER.
THE HEALTH CARE BENEFIT PREVIOUSLY KNOWN AS TRS IS
RENAMED TRS TIER 1.  QUALIFICATION FOR TIER 1 IS BASED UPON
ACTIVATION IN SUPPORT OF A CONTINGENCY OPERATION.  PER PARAGRAPH 1
(ABOVE), INFORMATION CONCERNING TRS TIERS 2 AND 3 WILL BE PUBLISHED
VIA SEPARATE MARADMIN.
3.  PROGRAM SUMMARY (TIER 1).  QUESTIONS CONCERNING PROGRAM
BENEFITS, ELIGIBILITY, AND ENROLLMENT PROCEDURES SHOULD BE
ADDRESSED TO EACH UNIT'S TRS REP.  TRS REPS MAY CONTACT THE POCS
LISTED IN PARA 7 AND 8 (BELOW).
A.  COSTS AND FEES.
(1)  PREMIUMS (ADJUSTED EACH CALENDAR YEAR BASED ON 28 PERCENT OF
THE AVERAGE PREMIUMS FOR PRIVATE EQUIVALENT INSURANCE): CURRENTLY,
$81 PER MONTH FOR MEMBER ONLY, $253 PER MONTH FOR MEMBER AND FAMILY
COVERAGE.
(2)  ANNUAL (FY) DEDUCTIBLES: $50 PER INDIVIDUAL, $150 PER FAMILY
FOR CORPORALS AND BELOW.  $150 PER INDIVIDUAL, $300 PER FAMILY FOR
SERGEANTS AND ABOVE.
(3)  COST SHARES (OUTPATIENT): 15 PERCENT ON-NETWORK, 20 PERCENT
OFF-NETWORK.
(4)  CATASTROPHIC CAP: $1000 PER FY.
B.  QUALIFYING CRITERIA.
(1)  EVERY 90 DAYS OF CONTINUOUS ACTIVATION IN SUPPORT OF A
CONTINGENCY OPERATION ACCRUES ONE ADDITIONAL YEAR OF COVERAGE.
A BREAK IN SERVICE GREATER THAN 24 HOURS SHALL NOT BE CONSIDERED
CONTINUOUS.  PER THE EXAMPLES IN PARA 3B(5), SERVICE INCREMENTS LESS 
THAN 90 DAYS SHALL BE ROUNDED DOWN TO THE NEXT LOWER INCREMENT 
(I.E., 269 DAYS ACCRUES 2 YEARS OF COVERAGE, 270 DAYS ACCRUES 
3 YEARS OF COVERAGE.)
(2)  MEMBERS WHO DEACTIVATE EARLY DUE TO A SERVICE CONNECTED
INJURY, ILLNESS, OR DISEASE ARE ELIGIBLE FOR NO LESS THAN ONE YEAR
OF COVERAGE.
(3)  MULTIPLE PERIODS OF COVERAGE BASED ON NEW QUALIFYING ACTIVE
DUTY FOR WHICH THE PERIOD OF SERVICE OR 180-DAY TRANSITION
ASSISTANCE MANAGEMENT PERIOD (TAMP) PERIOD ENDED ON OR AFTER
6 JAN 06 SHALL RUN CONSECUTIVELY.
(4)  MULTIPLE PERIODS OF COVERAGE BASED SOLELY ON QUALIFYING ACTIVE
DUTY FOR WHICH THE PERIOD OF SERVICE OR 180-DAY TAMP PERIOD ENDED
PRIOR TO 6 JAN 06 SHALL RUN CONCURRENTLY.
(5)  EXAMPLES.
(A)  EXAMPLE 1.  A RESERVE MEMBER IS ACTIVATED ON 1 JUNE 2002,
DEPLOYS TO AFGHANISTAN IN AUGUST, AND RETURNS TO CONUS IN MARCH
2003.  UPON DEACTIVATION, THE MEMBER'S EAS IS MODIFIED TO 15 MAY
2003.  THE MEMBER IS ELIGIBLE FOR 3 YEARS OF COVERAGE (349 DAYS 
DIVIDED BY 90 DAYS = 3.88).  AS PART OF THE HISTORICAL GROUP (SEE 
PARA 3C(1)), THE MEMBER MUST ENROLL IN TIER 1 COVERAGE WITH AN 
EFFECTIVE DATE NLT 28 OCTOBER 2005.
(B)  EXAMPLE 2.  AFTER A 5-DAY BREAK IN SERVICE, THE SAME MEMBER
IS AGAIN ACTIVATED AS AN INDIVIDUAL AUGMENT FOR 8 MONTHS DUTY CONUS.
THE MEMBER COMPLETES THE NEW PERIOD OF SERVICE BEGINNING ON 21 MAY
03 AND DEACTIVATES ON 20 JANUARY 2004.  BASED ON THIS PERIOD OF
SERVICE, THE MEMBER IS ELIGIBLE FOR 2 YEARS OF COVERAGE (245 DAYS
DIVIDED BY 90 DAYS = 2.72), AND AS PART OF THE HISTORICAL GROUP, 
MUST ENROLL IN TIER 1 COVERAGE WITH AN EFFECTIVE DATE NLT 
28 OCTOBER 2005.  ADDITIONALLY, THE MEMBER MUST ELECT COVERAGE 
BASED ON A SINGLE PERIOD OF ACTIVE DUTY AND CANNOT COMBINE 
ELIGIBILITY FROM BOTH PERIODS OF SERVICE.  SINCE THE FIRST PERIOD
IS MOST BENEFICIAL, THE MEMBER ENTERS INTO AN AGREEMENT ON 1 MAY 2005
AND BEGINS HIS THREE YEARS OF TIER 1 COVERAGE EFFECTIVE THIS DATE.
(C) EXAMPLE 3.  THE SAME MEMBER IS AGAIN ACTIVATED, FOR ONE YEAR,
ON 16 MAY 2005, DEPLOYS TO IRAQ IN JUNE, AND RETURNS TO CONUS IN
DECEMBER 2005.  UPON DEACTIVATION, THE MEMBER'S EAS IS MODIFIED TO
31 DECEMBER 2005.  THE MEMBER'S 180-DAY TAMP PERIOD ENDS ON 29 JUNE
2006.  BASED ON THIS PERIOD OF SERVICE, THE MEMBER IS ELIGIBLE FOR
2 YEARS OF COVERAGE (230 DAYS DIVIDED BY 90 DAYS = 2.56).  
SINCE THE MEMBER'S 180-DAY TAMP PERIOD ENDED AFTER 6 JANUARY 2006, 
THE MEMBER IS ELIGIBLE TO ELECT 2 ADDITIONAL YEARS OF TIER 1 COVERAGE
FOR A TOTAL OF 5 YEARS WHEN COMBINED WITH THE PREVIOUS ELECTION.  
NOTE: IF THE MEMBER HAD PREVIOUSLY DECLINED COVERAGE IN EXAMPLES 
1 AND 2 (ABOVE), THEN ELIGIBILITY WOULD BE LIMITED TO 2 YEARS OF
COVERAGE WITH AN EFFECTIVE START DATE OF 30 JUNE 2006 (SEE PARA
3C(2)).
C.  COVERAGE START DATE.
(1)  HISTORICAL GROUP (MEMBERS WITH AN EAS ON OR BEFORE 26 APRIL
2005): NLT 28 OCTOBER 2005.
(2)  SELECTED RESERVE: EXPIRATION OF 180-DAY TAMP (EAS + 181 DAYS).
(3)  IRR MEMBERS (SEE IRR RULE IN PARA 5B (BELOW)): DATE OF
SELECTED RESERVE AFFILIATION OR EXPIRATION OF 180-DAY TAMP,
WHICHEVER IS LATER.  IN NO CASE, SHALL THIS DATE BE GREATER THAN
ONE YEAR FROM THE EXPIRATION OF THE 180-DAY TAMP.
D.  PERIOD OF COVERAGE.
(1)  PRIOR TO 6 JANUARY 2006, COVERAGE RUNS CONCURRENT TO ANY
ACTIVE DUTY BENEFITS.
(2)  BEGINNING 6 JANUARY 2006, TRS COVERAGE RUNS CONSECUTIVELY
WITH OTHER ACTIVE DUTY BENEFITS GREATER THAN 30 DAYS IN DURATION.
(I.E., A MEMBER WHO IS ACTIVATED FOR ONE YEAR MAY HAVE HIS OR HER
COVERAGE EXTENDED BY 90 DAYS (EID), 365 DAYS (ACTIVE DUTY), AND 180
DAYS (TAMP) FOR A TOTAL OF 635 DAYS).
(3)  RESPONSIBILITY FOR PAYMENT OF PREMIUMS IS SUSPENDED WHILE
COVERED UNDER AN ACTIVE DUTY BENEFIT OF GREATER THAN 30 DAYS
DURATION.  PREMIUM PAYMENTS WILL NOT BE SUSPENDED FOR IDT OR 14-DAY
ANNUAL TRAINING.
(4)  PARA D(2) (ABOVE) DOES NOT APPLY TO A MEMBER WHO RECEIVES
HEALTH CARE BENEFITS DUE TO AN ACTIVE DUTY SPOUSE.
E.  TERMINATION OF COVERAGE.
(1)  EXPIRATION OF ELIGIBILITY.
(2)  SEPARATION FROM THE SELECTED RESERVE.
(A)  TRANSFER TO THE IRR, ASL, OR ISL FOR A SINGLE DAY.
(B)  TRANSFER TO THE SELECTED RESERVE OF ANOTHER SERVICE WITH A
BREAK IN SERVICE GREATER THAN 24 HOURS.
(3)  FAILURE TO EXTEND OR REENLIST.
(4)  FAILURE TO MAKE PREMIUM PAYMENTS.  NOTE: THE MEMBER WILL STILL
BE RESPONSIBLE FOR PREMIUM PAYMENTS UNTIL FORMALLY DISENROLLED FROM
COVERAGE (NORMALLY TWO MONTHS).
(5)  VOLUNTARY TERMINATION.  THE EFFECTIVE DATE FOR TERMINATION OF
COVERAGE WILL BE THE LAST DAY OF THE MONTH IN WHICH THE REQUEST WAS
RECEIVED BY THE REGIONAL TRICARE CONTRACTOR.
F.  DEATH OF A COVERED MEMBER.  FAMILY MAY CONTINUE OR ENROLL IN
TIER 1 COVERAGE FOR A PERIOD OF UP TO 6 MONTHS AFTER THE DEATH OF
A SPONSOR.
4.  ENROLLMENT PROCEDURES.  OBTAINING TIER 1 COVERAGE IS A 3 STEP
PROCESS.
A.  ENTER INTO AN AGREEMENT (DD 2895).
B.  LOGON TO THE TRS WEBSITE (URL LISTED IN PARA 8B).
(1)  MEMBER ENTERS ELECTION.
(2)  UNIT TRS REP EXECUTES THE AGREEMENT.
(3)  MEMBER COMPLETES ENROLLMENT FORM.  NOTE: ENROLLMENT FORM WILL
NOT BE AVAILABLE ONLINE UNTIL THE UNIT TRS REP HAS EXECUTED THE
AGREEMENT.
C.  SUBMIT ENROLLMENT FORM WITH FIRST MONTH PREMIUM PAYMENT TO TRS
REGIONAL CONTRACTOR.
5.  DEADLINES.
A.  SMCR MEMBERS.  NOTE: SMCR INCLUDES THE IMA PROGRAM.
(1)  TO ACCEPT OR DECLINE COVERAGE ON THE TRS WEBSITE: NLT DATE OF
DEACTIVATION (EAS).  SMCR MEMBERS ARE AUTHORIZED TO CHANGE THEIR
INITIAL ELECTION UP TO 90 DAYS AFTER THEIR EAS.
(2)  TO ENTER INTO AN AGREEMENT (DD 2895): IMMEDIATELY UPON
ACCEPTANCE OF COVERAGE.  (NOTE: ENTERING INTO AN AGREEMENT DOES NOT
OBLIGATE THE MEMBER TO REENLIST OR AFFILIATE WITH THE SELECTED
RESERVE.  AS SUCH, MEMBERS ARE ENCOURAGED TO ENTER INTO AN AGREEMENT
FOR THE MAXIMUM PERIOD OF ELIGIBILITY AS COMPUTED UNDER PARA 3B.)
(3)  TO EXECUTE THE AGREEMENT ON THE TRS WEBSITE (SEE PARA 8B) BY
UNIT TRS REPS:  IMMEDIATELY UPON COMPLETION OF THE DD 2895 IN PARA
5A(2)  (ABOVE).
(4)  TO SUBMIT AN ENROLLMENT FORM: MUST BE RECEIVED BY THE TRS
REGIONAL CONTRACTOR 30 DAYS BEFORE THE START OF COVERAGE.
B.  IRR MEMBERS.  NOTE: AN SMCR MEMBER WHO TRANSFERS TO THE IRR
PRIOR TO THE END OF THE 180-DAY TAMP IS CONSIDERED TO BE AN IRR
MEMBER FOR PURPOSES OF DETERMINING EFFECTIVE DATE OF COVERAGE AND
DEADLINES.
(1)  TO ACCEPT OR DECLINE COVERAGE ON THE TRS WEBSITE: NLT DATE OF
DEACTIVATION (EAS).  IRR MEMBERS ARE AUTHORIZED TO CHANGE THEIR
INITIAL ELECTION UP TO 30 DAYS AFTER AFFILIATION WITH THE SELECTED
RESERVE, WHICH MUST BE WITHIN ONE YEAR OF THE END OF TAMP.
(2)  TO ENTER INTO AN AGREEMENT (DD FORM 2895):  IMMEDIATELY UPON
ACCEPTANCE OF COVERAGE.
(3)  TO EXECUTE THE AGREEMENT ON THE TRS WEBSITE (SEE PARA 8B) BY
UNIT TRS REPS: IMMEDIATELY UPON COMPLETION OF THE DD 2895 IN PARA
5A(2) (ABOVE).
(4)  TO SUBMIT AN ENROLLMENT FORM: MUST BE RECEIVED BY THE TRS
REGIONAL CONTRACTOR WITHIN 30 DAYS OF SMCR AFFILIATION.
6.  TASKS.  RESERVE UNITS, DPCS, RSUS, AND MOBCOM SHALL
A.  APPOINT A PRIMARY AND ALTERNATE TRS REP.  REPORT CURRENT AND
FUTURE CHANGES TO TRS REPS TO MARFORRES(G1).  ACTIVE DUTY I&I
STAFF MAY ACT AS THE TRS REP FOR MULTIPLE CO-LOCATED RESERVE UNITS.
BN OR SQDN LEVEL REPS AND HIGHER SHALL ACT AS SITE SECURITY MANAGERS
(SSM).  SSM REQUIREMENTS INCLUDE ESTABLISHING AND TRACKING TRS REP
ACCOUNTS FOR UNITS UNDER THEIR COMMAND.
B.  ENSURE ALL DEACTIVATING MARINES RECEIVE A BRIEF ON TIER 1
BENEFITS AND ENROLLMENT PROCEDURES PRIOR TO THEIR EAS.  ELIGIBLE
NEW JOINS FROM THE IRR WILL RECEIVE A BRIEF ON TIER 1 BENEFITS
WITHIN 5 WORKING DAYS OF UNIT AFFILIATION.
C.  ENTER THE FOLLOWING PAGE 11 ENTRY INTO THE SERVICE RECORD
JACKET OF ALL MEMBERS DESIGNATED IN PARA 6B (ABOVE) SIGNIFYING THE 
MEMBER'S DECISION TO ACCEPT OR DECLINE TIER 1 COVERAGE.  USE OF 
LABELS IS AUTHORIZED.  I HAVE BEEN BRIEFED ON MY ELIGIBILITY FOR 
TRS TIER I COVERAGE.  I CHOOSE TO ACCEPT OR DECLINE TIER I COVERAGE.
D.  VALIDATE DEERS DATA ON THE TRS WEBSITE.  INCONSISTENCIES SHOULD
BE ADDRESSED TO THE NEAREST RAPIDS SITE PERSONNEL OR DMDC AT THE
POC LISTED BELOW IN PARA 7B.
E.  ENSURE ALL DEACTIVATING MARINES HAVE AN INITIAL ELECTION
ACCEPTING OR DECLINING TIER 1 COVERAGE ON THE TRS WEBSITE PRIOR TO
THEIR EAS.
F.  EXECUTE ALL AGREEMENTS IMMEDIATELY ON THE TRS WEBSITE.  FILE
THE COMPLETED ORIGINAL DD 2895 AS THE TOP DOCUMENT ON THE DOCUMENT
SIDE OF THE MEMBER'S SERVICE RECORD JACKET.
G.  MONITOR ENROLLMENT STATUS OF ALL ELIGIBLE MARINES.
SPECIFICALLY, REVALIDATE THE ELECTION OF ALL MARINES WHO HAVE
PREVIOUSLY ELECTED COVERAGE, BUT NOT YET ENROLLED BY THE 180TH DAY
AFTER THEIR EAS.  A ROSTER (UPDATED WEEKLY) IS AVAILABLE ON THE RAP
WEBSITE (PARA 7C) UNDER FORMS -> TRS STATS.
H.  MARINES WHO HAVE ACCEPTED TIER 1 COVERAGE AND FAILED TO SUBMIT
AN ENROLLMENT FORM TO TRICARE WITHIN THE APPROPRIATE TIMELINE
PRESCRIBED IN PARA 5A(4) AND 5B(4) (ABOVE), MAY CHANGE THEIR
ELECTION TO DECLINE.  PER PARA 6C (ABOVE), A SERVICE RECORD JACKET
PAGE 11 ENTRY IS REQUIRED DOCUMENTING THE DECISION.  ADDITIONALLY, 
THE TRS REP SHALL INVALIDATE THE INITIAL ELECTION AND ENTER DECLINE 
ON BEHALF OF THE MEMBER.
7.  QUESTIONS ABOUT TRS.
A.  ELIGIBILITY.  ELIGIBILITY QUESTIONS SHOULD BE ADDRESSED TO THE
MEMBER'S TRS REP.
B.  ELIGIBILITY ERRORS.  IF A UNIT BELIEVES THAT A MEMBER'S
ELIGIBILITY IS INACCURATE AND CANNOT BE CHANGED VIA THE NEAREST
RAPIDS SITE, THE UNIT TRS REP SHOULD CONTACT THE DMDC MARINE
CORPS LIAISON.  POC IS GYSGT ENOCH AT COMM 831.583.2400, x4224.
C.  TRS TRAINING INFORMATION, FAQS, DD 2895, WEBSITES, POWERPOINT
PRESENTATIONS, AND UNIT POCS CAN BE FOUND ON THE RESERVE AFFAIRS
POLICY HOMEPAGE: GO TO WWW.USMC.MIL, AND FOLLOW THE LINKS TO ->
CAREER -> MANPOWER AND RESERVE AFFAIRS -> RESERVE MARINE -> RESERVE
AFFAIRS (RA) -> RESERVE AFFAIRS POLICY (RAP) -> PERSONNEL POLICY ->
RESERVE BENEFITS -> TRICARE RESERVE SELECT.
D.  TRS REP VERIFYING OFFICER PASSWORD RESET, CONTACT DMDC
APPLICATION ASSISTANCE HELPLINE AT 800.372.7437 OR 800.538.9522.
E.  ENROLLMENT PROCEDURES.  POC IS CAPT JACOBS AT (504) 678-5604
OR HMC BAILEY AT (504) 678-6384.
8.  ADDITIONAL TRICARE INFORMATION.  THE FOLLOWING IS A LIST OF
SOURCES FOR ADDITIONAL TRICARE INFORMATION.
A.  ACCESS THE TRICARE WEBSITE AT WWW.TRICARE.OSD.MIL OR CALL
888.DOD.CARE (363.2273).
B.  TO LOCATE THE NEAREST DEERS-RAPIDS SITE ACCESS THE DMDC WEBSITE
AT WWW.DMDC.OSD.MIL(SLASH)GUARD-RESERVEPORTAL.  THIS IS ALSO THE SITE
FOR TRS AGREEMENT & ENROLLMENT FORMS.
C.  TO CONTACT THE NEAREST REGIONAL TRICARE BENEFICIARY COUNSELING
AND ASSISTANCE COORDINATOR (BCAC), ACCESS THE LIST OF BCAC NAMES
AND TELEPHONE NUMBERS AVAILABLE AT
WWW.TRICARE.OSD.MIL(SLASH)BCACDIRECTORY.HTM.