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TRICARE Operations Manual 6010.59-M, April 1, 2015
Communications and Customer Service (C&CS)
Chapter 11
Section 1
Education Requirements
Revision:  C-26, May 30, 2018
The education of TRICARE beneficiaries, TRICARE providers, and Military Health System (MHS) staff and providers shall be accomplished through a collaborative effort between Defense Health Agency (DHA) Communications, the Managed Care Support Contractors (MCSCs), and other TRICARE contractors. This collaboration will ensure information and education about the TRICARE Program, policies, health care delivery requirements, and changes and/or addition to benefits are effectively provided. Educational activities include research and analysis to determine targeted audience and the provision of educational materials, and training programs and briefings in accordance with Section 2. The Government will furnish all printed educational materials, except for region specific provider education materials. The contractor and/or other TRICARE contractors shall be responsible for the individual distribution of Government-furnished materials.
1.0  Education Plan
The contractor shall submit an annual education plan to inform and educate TRICARE beneficiaries, TRICARE and MHS staff, and providers on all aspects of TRICARE programs. DHA Communications and the TRICARE Regional Office (TRO) will review the plan, and provide concurrence or appropriate feedback for recommended changes.
2.0  INTERFACE REQUIREMENTS
2.1  The contractor shall participate in monthly TRICARE beneficiary and provider work group meetings, comprised of the TROs marketing representatives, OCONUS marketing representative and the TRICARE Beneficiary Publications Office/DHA Communications. As advisors, the contractors shall provide unique perspectives, ideas, and recommendations regarding the development and maintenance of TRICARE educational materials to the group. The goal of the monthly meetings is to present status updates on production, address issues, and provide new information and propose new ideas for products and/or initiatives. The contractor shall provide a primary and alternate representative for attendance and participation in the monthly meetings, to be held approximately 12 times per contract year in the Washington, DC area. Meetings may be attended via teleconference, video telecommunications, or in person, as directed by the Government.
2.2  All requests for marketing and educational materials shall be submitted by the contractor via the appropriate TRO for review and consideration. Approval shall be based on justification that supports a uniform image and consistency in the provision of TRICARE Program information, and available funding.
3.0  Required Educational Materials
The Government will provide to the contractor all beneficiary educational and enrollment materials which may include printed and electronic media. Materials developed by the Government and distributed in support of the TRICARE program will be selected on the basis of recommendations by contractors, program managers, the Services, Defense Health Agency (DHA) leadership and others with interests and concerns about the information being provided to TRICARE beneficiaries and other stakeholders. DHA Communications and the TROs will review all recommendations and prioritize products in accordance with funding availability. DHA Communications will have final approval authority. The contractor shall be responsible for the distribution of Government-furnished materials to MHS beneficiaries. The Government will provide all enrollment materials for distribution by the contractor to MHS beneficiaries. The enrollment form will be provided electronically.
4.0  Dissemination Of Information
4.1  The contractor shall distribute TRICARE information using effective methods (for example, e-mail, World Wide Web (WWW), telephone, testing, and smart phone applications, and other social media) that ensure timely delivery and receipt to all MHS beneficiary households in the region based on Defense Enrollment Eligibility Reporting System (DEERS) data. (Note: The Department of Defense (DoD) does not maintain beneficiary e-mail addresses.) In addition, the contractor shall do a mailing pertaining to a benefit update, within the stated contract period, to all eligible beneficiary households. The contractor shall furnish enrollment information and forms, network provider information, Health Care Finder (HCF) information, claims forms, claim completion instructions, a web link to the TRICARE Handbook, DEERS information and other informational materials upon request to beneficiaries, providers, and Congressional offices. The contractor shall establish and maintain effective communications with all beneficiaries (see Section 3). Details for submission of the Education Plan are identified by DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract.
4.2  The contractor shall be responsible for all provider education, which includes producing and distributing an annual Provider Handbook, newsletters, and/or bulletins. The contractor may use any method of distribution that ensures timely receipt by all providers. Copies of TRICARE educational materials distributed to providers shall be provided to the DHA Director, TROs/Program Office, DHA Communications, and Congressional offices. The Government reserves the right to evaluate the success of the contractor provider relations effort via scientific surveys and other data collection efforts with the network providers.
4.3  The contractor shall distribute a quarterly newsletter to all TRICARE Prime enrollees, including active duty personnel, dual-eligible beneficiaries enrolled in TRICARE Prime, Congressional offices, and Beneficiary Counseling and Assistance Coordinators (BCACs). The contractor shall distribute an annual newsletter to TRICARE beneficiaries not enrolled in Prime prior to the annual open enrollment period. Newsletters will generally be no more than six double-sided pages in length (8½” x 11”). The contractor shall not modify the content or length of the beneficiary newsletter prior to distribution. The contractor may use any method of distribution that ensures timely delivery and receipt to all recipients.
4.4  The TDEFIC contractor shall maintain a supply of TRICARE For Life (TFL) beneficiary educational materials. The TDEFIC contractor shall provide a copy of the most recent information upon request.
5.0  Ordering Education Materials
5.1  The contractor shall provide one representative for attendance and participation in the work group meeting to be held in the Washington, DC area. Meetings may be attended via teleconference, video telecommunications or in person, as directed by the Government. As stated, for each contract year, the committee will conduct one extensive meeting to determine the core educational materials to be developed for the following fiscal year. Contractors may be required by their TRO/Program Office to participate in this extensive, possibly multi-day, meeting in Washington, DC area.
5.2  Requests for additionally designed educational and enrollment materials not included in the initial request shall be submitted in accordance with paragraph 2.2. Upon determination of the core products, the contractors shall submit a request for copies required and delivery dates requested. The contractors shall provide DHA Communications with a single Point Of Contact (POC) and address(es) for delivery of educational materials.
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