3.0 QUALIFYING
TO PURCHASE TYA COVERAGE
3.1 In order to purchase TYA coverage,
young adult dependents who meet the qualifications listed in
paragraph 3.4 and
must be listed in the Defense Enrollment Eligibility Reporting System
(DEERS) database. DMDC will ensure that dependents meeting the qualifications
will be reflected as eligible to purchase or continue TYA coverage
if the Uniformed Service sponsor is eligible for health care under
Chapter 55, 10 USC or Chapter 58, 10 USC Section 1145(a), Transitional
Assistance Management Program (TAMP).
3.2 The contractor
shall rely solely upon DEERS to identify young adult dependents
qualified to purchase TYA coverage.
3.3 The contractor
shall refer young adult dependents and Uniformed Service sponsors
to the Real-Time Automated Personnel Identification System (RAPIDS)
site if the dependent is not found in DEERS.
3.4 Dependent Qualifications For
Purchase Of TYA Coverage
A young
adult dependent qualifies to purchase TYA coverage if the dependent
meets the following criteria:
3.4.1 Would
be a dependent child under Chapter 55, 10 USC Section 1072(2) but
for exceeding the age limit under that section,
3.4.2 Is a dependent
under the age of 26,
3.4.3 Is not eligible for medical
coverage from an eligible employer-sponsored health plan from the
young adult dependent’s employer as defined in Section 5000A(f)(2)
of the Internal Revenue Code of 1986,
• Is not married,
• Is not otherwise eligible for
care under Chapter 55, 10 USC or Chapter 58, 10 USC Section 1145(a),
TAMP,
• Is not a member of the Uniformed
Services.
3.5 Eligibility
Of Uniformed Service Sponsor
3.5.1 Eligibility for TYA is only
determined by a proper eligibility response in DEERS. Based on the
status of the Uniformed Service sponsor, the ability to purchase
may be limited or not allowed based on the Uniformed Service sponsor’s
status and eligibility for medical care under Chapter 55, 10 USC
or Chapter 58, 10 USC Section 1145(a). In addition, young adult
dependents must meet all other qualifications shown in
paragraph 3.4
3.5.2 Young
adult dependents of active duty members (including those called
to active duty for more than 30 calendar days) may qualify to purchase
TYA coverage until the active duty sponsor’s date of separation
or until the young adult dependent reaches the age of 26, whichever
comes first.
3.5.3 Upon the death of an active
duty sponsor, former young adult dependents already aged out of
TRICARE are classified as Survivors and may qualify to purchase
TYA coverage up to the age of 26 but with Survivor (retiree) cost-shares.
3.5.4 Young
adult dependents of retired Uniformed Service sponsors may qualify
to purchase TYA coverage until they reach the age of 26.
3.5.5 Young
adult dependents of Uniformed Service sponsors eligible to purchase
TRS or TRICARE Retired Reserve (TRR) may qualify to purchase TYA
coverage only if the sponsor is enrolled in TRS or TRR and until
the young adult dependent reaches age 26.
3.5.6 Failure
of the Uniformed Service sponsor to enroll in and maintain enrollment
in TRS or TRR or failure to pay TRS or TRR premiums will result
in the young adult dependent not being eligible to purchase TYA
coverage as of the date of the sponsor’s loss of enrollment in TRS
or TRR.
3.5.7 If the Selected Reserve sponsor
dies while enrolled in TRS, the young adult dependent may qualify
to purchase TYA coverage for up to six months after the date of
death of the Selected Reserve sponsor, or until the young adult
dependent reaches the age of 26, whichever comes first, but with
Survivor (retiree) cost-shares.
3.5.8 Young
adult dependents of a member of the TRR, who dies while in a period
of TRR coverage, may qualify to purchase new or continue existing
TYA coverage until the young adult dependent reaches the age of
26.
3.5.9 If a member of the TRR is not
covered by TRR on the date of his or her death, his or her surviving dependents
do not qualify for TYA coverage until the date on which the deceased
member of the TRR would have attained age 60, at which time they
may qualify to purchase TYA coverage until reaching the age of 26.
3.5.10 Young adult dependents of a
member eligible for TAMP coverage may qualify to purchase TYA coverage
until the TAMP coverage ends or the young adult dependent reaches
age 26, whichever comes first.
3.5.11 If the member dies while covered
under TAMP, the young adult dependent may qualify to purchase TYA coverage
to the end of the TAMP coverage period or until the young adult
dependent reaches age 26, whichever comes first, with Active Duty
Family Member (ADFM) cost-shares.
4.0 COVERAGE-RELATED
PROCEDURES
The TRICARE
Overseas Program (TOP) contractor shall perform these services for
young adult dependents residing outside of the 50 United States
(US) or the District of Columbia.
4.1 Coverage
Requests
4.1.1 The contractor shall accept
completed TYA enrollment requests presented from the Government-furnished
web-based self-service enrollment system/application as well as
those presented by phone, by mail, TRICARE Service Centers (TSCs)
operated by the TOP contractor, and other means determined by the
contractor.
4.1.2 To purchase, change or terminate
TYA coverage, qualified young adult dependents must present a complete
request within deadlines specified in the following paragraphs.
4.1.3 The contractor
shall reject and return incomplete requests along with any incorrect
premium payments to the applicant, within 10 business days, with
an explanation of what is needed for the contractor to accept the application
for processing.
4.1.3.1 If a qualified young adult
dependent would like to change coverage from TYA Select to TYA Prime,
a separate application must be submitted.
4.1.3.2 The contractor shall accept
and process requests up to 90 calendar days before the end of the
12-month lockout period if an enrollment lockout is in place (refer
to
paragraph 4.1.4.3). The procedures for determining
the effective date of coverage are specified in the following paragraphs.
4.1.4 The contractor
shall meet the following requirements in order for a request to
be complete.
4.1.4.1 Collect an initial payment
equal to two months of premium applicable for the type of coverage requested.
The initial payment may be made with a personal check, cashier’s
check, money order, credit or debit card (i.e., Visa or MasterCard).
4.1.4.2 Ensure that the request contains
account information for collection of ongoing monthly premium payments
by either a Recurring Credit Card or Debit Card (RCC) (i.e., Visa
or MasterCard) payment or an Electronic Funds Transfer (EFT). The
contractor is not required to validate the account information at
the time of receipt.
4.1.4.3 Accept completed requests for
new coverage when a lockout is in effect for up to 90 calendar days before
the end of the 12 month lockout period. The new coverage is to begin
after the 12-month lock period ends.
4.1.4.4 Ensure requests generated from
the web application and presented (by mail or in-person) as hard copy
shall contain an original signature.
4.1.4.5 Ensure requests generated from
the web application and presented electronically shall be signed electronically.
4.1.4.6 Review all information in the
signature block on the applicable form with the requestor for requests presented
verbally on the phone.
4.1.4.6.1 The contractor shall ask if
the requestor agrees to the terms and conditions presented to them.
4.1.4.6.2 The contractor shall reject
the request and document in the contractor’s call notes accordingly
if the requestor does not agree.
4.1.4.6.3 The contractor shall document
agreement in the contractor’s call notes accordingly and continue with
processing the request if the requestor agrees.
4.2 Continuous
Open Enrollment
A qualified
young adult dependent may purchase TYA coverage throughout the year
unless locked out from TYA coverage.
4.2.1 TYA
Select
The effective
date of TYA Select coverage shall be the date the completed request
(refer to
paragraph 4.1) is received by the contractor
or a date up to 90 calendar days in the future as specified by the
requestor.
4.2.2 TYA Prime Plans
4.2.2.1 The effective date of TYA Prime
coverage shall be the date the completed request is received by
the contractor or a date up to 90 calendar days in the future as
specified by the requestor.
4.2.2.2 Young adult dependents may
qualify to purchase TOP Prime or TOP Prime Remote plan coverage (refer
to
Chapter 24, Section 5).
4.2.2.3 Young adult dependents may
request cross-geographical area of responsibility enrollment (refer
to
Chapter 6, Section 1) but apply using the
TYA Application (DD Form 2947) in accordance with
paragraph 4.5.
4.2.2.4 The contractor shall notify
TYA Prime enrollees who no longer meet TRICARE Prime enrollment requirements
(refer to
Chapter 6, Section 1) that their TYA coverage
will be terminated on the first of the month following 30 calendar
days from the initial notification date and the option of applying
for TYA Select coverage refer to (
paragraphs 4.1 and
4.4).
No lockout shall be applied.
4.3 Continuation
Coverage
4.3.1 A qualified young adult dependent
may purchase TYA coverage with an effective date immediately following
the termination of coverage under another TRICARE program, including
the CHCBP.
4.3.2 The completed TYA request required
by
paragraph 4.1 must either be received by the
contractor or TOP contractor by phone, entered into the Government-furnished
web-based self-service enrollment system/application, or postmarked
no later than 90 calendar days following termination of coverage.
4.3.3 The contractor
shall process the application as a new request if the young adult
dependent does not meet the requirement for continuation coverage.
4.3.4 The contractor
shall process the application as an open enrollment request if the
young adult dependent does not meet the requirement for continuation
coverage. (See the TRICARE Policy Manual (TPM),
Chapter 10, Section 4.1, for information regarding
the CHCBP).
4.4 Changing
Coverage Within The Same Contractor
4.4.1 Upon receipt
of a completed request (refer to
paragraph 4.1), qualified
dependents already enrolled in a TYA plan and who are current in
their premium payments may elect to change to another TYA plan for
which the qualified dependent is eligible based on the sponsor’s
eligibility and the geographic location of the qualified young adult
dependent. Changes in coverage are effective following the application
processing time frames listed in
paragraph 4.6.
4.4.2 The contractor
shall, if the premium amount changes, adjust future premiums by
applying any overages to future TYA premium payments and adjusting
the (EFT or RCC) payments so the young adult dependent is not over
or undercharged for the coverage requested.
4.5 Transfer of Coverage to Another
Contractor
4.5.1 The gaining contractor shall
process valid transfer requests within 10 calendar days. Changes
in coverage are effective following the request processing time
frames listed in
paragraph 4.6.
4.5.1.1 Young adult dependents desiring
to transfer TYA coverage to another contractor must submit a completed
request (refer to
paragraph 4.1) to the desired contractor.
4.5.1.2 Transfer of TYA coverage to
another contractor is only permitted if the young adult dependent
is current with his or her premiums.
4.5.2 The contractor
shall, if the premium amount changes, adjust future premiums by
applying any overages to future TYA premium payments, and adjusting
the EFT or RCC payments so the young adult dependent is not over
or undercharged for the coverage requested.
4.6 Processing
4.6.1 The contractor
shall process all TYA transactions through the Government-furnished
web-based system/application for young adult dependents with a residential
address as indicated by the TYA requestor on the TYA application
in the contractor’s jurisdiction.
4.6.2 Premium-related
transactions shall be reported through the enrollment fee payment
interface or Catastrophic Cap and Deductible (CC&D) Fee website
(refer to the TRICARE Systems Manual (TSM),
Chapter 3, Section 4.2).
4.6.3 The contractor
shall process TYA completed requests (refer to
paragraph 4.1)
no later than 10 calendar days after receipt.
4.6.4 The contractor
shall assign Primary Care Managers (PCMs) to purchasers of TYA Prime
coverage per
Chapter 6.
4.6.5 The contractor shall notify
the young adult within 10 calendar days of receipt of the request
if the contractor is unable to enroll the young adult dependent
in the Government-furnished web-based system/application due to:
• A 90-day future enrollment
limitation;
• DEERS not reflecting eligibility;
or
• Any other Government-furnished
web-based system/application limitation.
4.6.6 The contractor
shall, in the notification described in
paragraph 4.6.5, offer to
return any premium payments collected to the member. The notice
shall explain what is needed for the contractor to accept the request for
processing.
Note: See the TSM,
Chapter 2, Addendum L, for a full list of
TRS Health Care Delivery Plan (HCDP) coverage code values.
4.7 Termination Of TYA Coverage
4.7.1 The contractor
shall initiate return of any excess premium amounts paid prorated
to the day as indicated no later than 10 calendar days after the
effective date of the termination or after receipt of a Government-furnished
policy notification of a termination, whichever is later.
4.7.2 Premium
refunds, to include an explanation of the premium refund, will be
sent to young adult dependent’s residential address unless an alternate
mailing address has been provided.
4.7.3 The contractor
shall update DEERS with any premium amount refunded within 30 calendar
days.
4.7.4 The contractor shall apply
a lockout on the occasion of termination of TYA coverage as specified
in the following paragraphs. When applied, a lockout shall remain
in effect for 12 months after the last paid-through date.
4.8 Loss
Of TYA Qualification
4.8.1 No lockout will be applied
for loss of qualification.
4.8.2 At any
time a young adult dependent ceases to meet all eligibility qualifications,
coverage under the TYA program shall terminate.
4.8.3 DEERS
will automatically enroll or change the enrollment of certain beneficiaries
as described in
Chapter 6, Section 1.
4.8.3.1 The contractor will receive
a Government-furnished policy notification advising it of all changes.
4.8.3.2 The effective date of termination
shall be the date upon which the young adult dependent ceased to meet
any of the prerequisite qualifications.
4.8.4 If a subsequent
change in circumstances occurs such as losing eligibility for an
eligible employer-sponsored plan, the young adult dependent may
qualify again to purchase coverage under the TYA program.
4.8.5 Young
adult dependents who age out of TYA at age 26 may be eligible to
purchase CHCBP coverage (see TPM,
Chapter 10, Section 4.1).
4.8.6 Upon termination
of coverage, DMDC will send a notification to the young adult dependent.
4.9 Change
in Sponsor Status
A change
in sponsor status (e.g., active to retired; active duty to the Reserve
Component (RC)), may require the young adult dependent’s coverage
to be transferred to another TYA coverage plan or cause TYA coverage
to be terminated.
4.10 TYA Select Coverage
4.10.1 DEERS will automatically enroll
or change the enrollment of certain beneficiaries as described in
Chapter 6, Section 1.
4.10.2 The contractor will receive
a Government-furnished policy notification advising it of all changes.
4.10.3 When a sponsor’s status changes,
coverage under a TYA Select coverage may be transferred in DEERS by
DMDC to an appropriate TYA Select plan consistent with the new sponsor
status unless the Uniformed Service sponsor is not eligible for
TRICARE coverage or the RC Uniformed Service sponsor is not enrolled
in TRR or TRS.
4.10.3.1 DEERS will send the contractor
with which the young adult dependent is enrolled an unsolicited Government-furnished
policy notification advising the contractor of the transferred coverage.
4.10.3.2 When a sponsor status changes
and the coverage cannot be transferred, DEERS will terminate the coverage.
4.10.3.3 If the termination date is
different from the anticipated end date, DEERS will notify the contractor with
an unsolicited Government-furnished policy notification that the
coverage is terminated. DMDC will send a notification to the young
adult dependent.
4.10.4 The contractor shall update
its fee system as appropriate.
4.10.5 The contractor shall, upon
receipt of an unsolicited Government-furnished policy notification
with an updated enrollment end reason code and an enrollment extension
end reason code indicating a TYA individual is again eligible for
TYA coverage after termination due to a change in sponsor status,
contact the TYA individual within 10 calendar days to offer enrollment
assistance if TYA coverage has not already been re-established.
4.11 TYA
Prime Coverage
4.11.1 The contractor shall update
the fee system based on the terminated coverage for the young adult dependent
as appropriate.
4.11.2 When a sponsor’s status changes,
coverage under TYA Prime plans is terminated in DEERS by DMDC.
4.11.3 If termination is at a date
other than the anticipated end date, DEERS will send the contractor
with whom the young adult dependent is enrolled (and if Market/MTF
enrollee) an unsolicited notification advising of the terminated
coverage.
4.11.4 DMDC will send a termination
notice (TN) to the young adult dependent advising them of the termination
of coverage.
4.11.5 The contractor shall contact
the young adult dependent within 10 calendar days to offer enrollment assistance
if TYA coverage has not already been re-established upon receipt
of an unsolicited Government-furnished policy notification with
an updated enrollment end reason code and an enrollment extension
end reason code indicating a young adult dependent is again eligible
for TYA coverage after termination due to a change in sponsor status.
4.11.6 If TYA eligibility is re-established
subsequent to a termination due to a sponsor status change, DMDC will
send an unsolicited Government-furnished policy notification with
an updated enrollment end reason code and an enrollment extension
end reason code.
4.12 Sponsor Loss of Eligibility
4.12.1 No lockout shall be applied
for sponsor loss of eligibility. When a sponsor‘s eligibility is
terminated, coverage under TYA is also terminated.
4.12.2 The contractor shall update
the fee system based on the terminated coverage for the young adult dependent
as appropriate if advised by DEERS of terminated coverage through
an unsolicited Government-furnished policy notification. This occurs
if a young adult dependent’s enrollment is terminated at a date
other than the anticipated end date.
4.12.3 The contractor shall terminate
coverage for the young adult dependent as appropriate (refer to
paragraph 4.7)
when eligibility is terminated at the anticipated end date. In this
case, DEERS will not send the contractor an unsolicited Government-furnished
policy notification advising the contractor of the terminated coverage.
Upon termination of coverage, DMDC will send a notification to the
young adult dependent.
4.13 Young
Adult Dependent Loss Of Eligibility
4.13.1 No lockout will be applied
for young adult dependent loss of eligibility.
4.13.1.1 If a young adult dependent’s
coverage is terminated at a date other than the anticipated end
date, DEERS will send the contractor with whom the young adult dependent
is enrolled an unsolicited Government-furnished policy notification
advising the contractor of the terminated coverage.
4.13.1.2 If a young adult dependent’s
coverage is terminated at the anticipated end date, DEERS will not
send the contractor with whom the young adult dependent is enrolled
an unsolicited Government-furnished policy notification advising
the contractor of the terminated coverage.
4.13.2 The contractor shall terminate
coverage for the young adult dependent as appropriate (refer to
paragraph 4.7).
4.13.3 The contractor shall update
the fee system based on the terminated coverage for the young adult dependent
as appropriate. DMDC will send a TN to the young adult dependent.
Upon termination of coverage, DMDC will send a notification to the
young adult dependent.
4.14 Young
Adult Dependent Gains Other TRICARE Coverage
No lockout shall be applied
for terminated coverage due to the gain of other TRICARE coverage.
4.15 Young
Adult Dependent Gains Own Eligible Employer-Sponsored Coverage
No lockout shall be applied
for termination due to eligibility for medical coverage offered
from an eligible employer-sponsored plan. The young adult dependent
must notify the contractor with a written request, the Government-furnished
web-based self-service enrollment system/application, or telephone
request (which is to be documented in the contractor’s call notes)
to terminate TYA coverage within 30 calendar days of when he or
she becomes eligible for an employer-sponsored health plan offered
by his or her employer.
4.15.1 If a young adult dependent
becomes eligible under an eligible employer-sponsored health plan
based on the young adult dependent’s employment for a period of
30 calendar days or less, TYA coverage will continue unchanged.
4.15.2 The contractor shall terminate
the TYA coverage using the Government-furnished web-based system/application
without applying a lockout upon notification from a young adult
dependent that he or she is eligible for medical coverage from an
eligible employer-sponsored health plan for a period of more than
30 calendar days.
4.16 Young Adult Dependent Loses
Eligibility Due To Non-Payment Of TRS Or TRR Premiums By Their Sponsor
No lockout shall be applied
for young adult dependents of a TRS or TRR sponsor that was disenrolled
and locked out for failure to pay TRS or TRR premiums. However,
until the TRS or TRR-eligible sponsor restores TRS or TRR coverage,
the young adult dependent does not qualify to purchase TYA coverage.
4.17 Failure
To Make Payment
4.17.1 Failure or refusal to pay monthly
premiums or any outstanding insufficient funds fees in accordance with
the procedures in this chapter shall result in termination of coverage
and a lockout as specified in
paragraph 4.7. The effective date of termination
is the first day following the paid-through date.
4.17.2 The contractor shall terminate
coverage of the young adult dependent if the monthly premium payment
is not received by the last day of the month following the due date
for the monthly premium payment.
4.17.3 The contractor shall terminate
coverage with a termination effective date retroactive to the last
paid-through date after the last day of the month.
4.17.4 Failure to provide information
to establish or maintain a recurring EFT or a RCC for monthly premium payment
will result in coverage being terminated for failure to comply with
paragraph 5.3 and
subordinate paragraphs.
4.17.5 DMDC sends written notification
of the termination and the lockout from the last paid-through date
to the young adult dependent.
4.17.6 The contractor shall pend any
claims received for health care furnished to the young adult dependent during
the period for which premiums have yet to be paid, until the termination
action is processed, to avoid creating recoupment of health care
costs for ineligible beneficiaries. The young adult dependent will
be responsible for the cost of any health care received after the
termination effective date following retroactive termination of
coverage.
4.17.7 The contractor shall initiate
recoupment of health care costs following the procedures in
Chapter 10, Section 3 if claims are not pended.
4.18 Requests
For Voluntary Termination
The contractor
shall apply a lockout as specified in
paragraph 4.7 for voluntary
termination requested by the young adult dependent unless the young
adult dependent is eligible for an employer-sponsored health plan.
DMDC sends written notification of the termination and the lockout
from the last paid-through date.
4.18.1 The contractor shall accept
requests for termination of coverage from young adult dependents
at any time. Termination of coverage requests includes those with:
• An original signature;
• A validated electronic signature
offered by and collected by the contractor;
• A verbal consent provided by
telephone and documented in the contractor’s call notes;
• A self-attestation by the beneficiary
when using the Government-furnished web-based self-service enrollment system/application
system.
4.18.2 The effective date of termination
is either:
• The last day of the month in
which the request was received by the contractor;
• The last day of a future month
as specified in the request given that the request was received
by the contractor in the month preceding the requested month of
termination;
• As directed by the waiver approval
authority for waiver cases.
4.19 Canceled
Eligibility And Enrollment
4.19.1 No lockout shall be applied
for a canceled enrollment.
4.19.2 The contractor shall notify
the young adult dependent of the cancellation and refund any unused portion
of the premium payment; including an explanation for the premium
refund when the contractor receives a Government-furnished policy
notification for a canceled enrollment.
4.19.3 The contractor shall update
DEERS with any premium amount refunded within 30 calendar days.
No lockout shall be applied for a canceled enrollment.
4.19.4 The contractor shall recoup
claims for the canceled enrollment period.
4.20 Reinstatement
4.20.1 The contractor shall accept
and honor a request from an otherwise qualified young adult to reinstate TYA
coverage retroactive to the last paid-through date with no justification
needed when a lockout is in effect if the request meets all of the
following conditions:
4.20.2 The request is received by
the contractor or postmarked no later than the first business day
of the fourth month after the paid-through date.
4.20.3 Payment of all premiums from
the last paid-through date through the current month, plus the amount for
the following two months is included (to include any administrative
fees)
4.20.4 Information is provided to
establish recurring electronic premium payments as specified in
paragraph 4.1.4.2.
4.20.5 The contractor shall reject
the request to reinstate coverage retroactively if any of the conditions
above are not met and inform the member or survivor of his or her
option to purchase new coverage after the 12-month lockout.
6.0 CLAIMS
PROCESSING
6.1 The contractor shall process
TYA claims using established TRICARE cost-sharing rules and guidance
based on the sponsor‘s status and the TYA plan purchased.
6.2 Claims
jurisdiction rules apply (refer to
Chapter 8, Section 2).
TRICARE Other Health Insurance (OHI) processing rules apply to TYA
except for claims from eligible employer-sponsored health plans
(refer to
paragraph 6.6).
6.3 The contractor
shall not recalculate the individual cost-shares, contributions
to the individual and family deductibles, and contributions to the
family catastrophic if a young adult dependent purchases TYA coverage during
the same calendar year that he or she had another TRICARE health
plan in effect.
6.4 Medicare is the primary payer
for TRICARE beneficiaries who are eligible for Medicare. Claims
under the TRICARE Medicare Eligible Program (TMEP) will be adjudicated
under the rules set forth in the TRM,
Chapter 4, Section 4.
6.4.1 The contractor
shall follow procedures established in
Chapter 8, Section 2 regarding
claims jurisdiction for dual eligibles.
6.4.2 Payment
of Medicare Part B premiums does not provide a basis to waive TYA
premiums.
6.5 The contractor shall initiate
recoupment of claims paid if appropriate as specified in
Chapter
10 when the contractor receives a Government-furnished
policy notification of a retroactive TYA disenrollment.
6.6 The contractor shall report
the discovery to the appropriate waiver approval authority no later
than one business day after discovery if at any time the contractor
discovers that the young adult dependent may be eligible or is enrolled
in an eligible employer-sponsored health plan from his or her employer.
6.6.1 The contractor
may pend claims until a final decision is reached.
6.6.2 The contractor
shall follow
paragraph 4.7 and its subordinate paragraphs
for loss of TYA eligibility, if applicable.
7.0 COMMUNICATIONS
AND CUSTOMER SERVICE (C&CS)
7.1 The contractor shall perform
C&CS functions to the same extent as it does for other TRICARE
plans in addition to C&CS functions specified throughout this
Chapter.
7.2 The contractor shall send fulfillment
materials only upon request.
7.3 Upon start
of coverage under TYA, the DMDC-generated enrollment notification
will include information on how purchasers can obtain TYA and other
TRICARE plan materials over the Internet or how to request fulfillment materials
from the contractor.
7.4 Customer Education
7.4.1 The contractor
shall distribute all informational materials associated with the
TYA program to the same extent and through the same means as other
TRICARE materials are distributed.
7.4.2 Materials
(e.g., public notices, flyers, informational brochures, website)
will be developed and distributed centrally by Department of Defense
(DoD), Defense Health Agency (DHA) Communications.
7.4.3 Copies
of TYA informational materials may be obtained through DHA Communications.
7.5 Customer
Service
The contractor
shall provide all customer service support to young adult dependents
in a manner equivalent to that provided to other TRICARE beneficiaries.