# Proposed Collection; Comment Request
**AGENCY:**
Office of the Assistant Secretary of Defense for Health Affairs (OASD(HA)), Department of Defense (DoD).
**ACTION:**
60-Day information collection notice.
**SUMMARY:**
In compliance with the *Paperwork Reduction Act of 1995,* the Defense Health Agency announces a proposed public information collection and seeks public comment on the provisions thereof. Comments are invited on: Whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; the accuracy of the agency's estimate of the burden of the proposed information collection; ways to enhance the quality, utility, and clarity of the information to be collected; and ways to minimize the burden of the information collection on respondents, including through the use of automated collection techniques or other forms of information technology.
**DATES:**
Consideration will be given to all comments received by June 28, 2022.
**ADDRESSES:**
You may submit comments, identified by docket number and title, by any of the following methods:
*Federal eRulemaking Portal: https://www.regulations.gov.* Follow the instructions for submitting comments.
*Mail:* Department of Defense, Office of the Assistant to the Secretary of Defense for Privacy, Civil Liberties, and Transparency, Regulatory Directorate, 4800 Mark Center Drive, Attn: Mailbox 24, Suite 08D09, Alexandria, VA 22350-1700.
*Instructions:* All submissions received must include the agency name, docket number and title for this *Federal Register* document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the internet at *https://www.regulations.gov* as they are received without change, including any personal identifiers or contact information.
**FOR FURTHER INFORMATION CONTACT:**
To request more information on this proposed information collection or to obtain a copy of the proposal and associated collection instruments, please write to Defense Health Agency, 8111 Gatehouse Road, 229D, Falls Church, VA 22042, ATTN: Shane Pham or call 703-275-6249.
**SUPPLEMENTARY INFORMATION:**
*Title; Associated Form; and OMB Number:* TRICARE Prime Enrollment, Disenrollment and Primary Care Manager Change Form; DD Form 2876: OMB Control Number 0720-0008.
*Needs and Uses:* The information collection requirement is necessary to obtain the TRICARE beneficiary's personal information needed to: (1) Complete his/her enrollment into TRICARE Prime health plan, (2) change the beneficiary's enrollment (new Primary Care Manager, enrolled region, add/drop a dependent, etc.), or (3) dis-enroll the beneficiary. All TRICARE beneficiaries have the option of enrolling, changing their enrollment or dis-enrolling using the DD Form 2876, the Beneficiary Web Enrollment portal, or by calling their regional Managed Care Support Contractor. Although the telephonic enrollment/change is the preferred method by the large majority of beneficiaries, many beneficiaries prefer using the form to document their enrollment date and preferences.
*Affected Public:* Individuals or households.
*Annual Burden Hours:* 760,025 hours.
*Number of Respondents:* 1,520,050.
*Responses per Respondent:* 2.
*Annual Responses:* 3,040,100.
*Average Burden per Response:* 15 minutes.
*Frequency:* On occasion.
Dated: April 26, 2022.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.