# Submission for OMB Review; Comment Request
**AGENCY:**
Office of the Assistant Secretary of Defense for Health Affairs (OASD(HA)), Department of Defense (DoD).
**ACTION:**
30-Day information collection notice.
**SUMMARY:**
The DoD has submitted to OMB for clearance the following proposal for collection of information under the provisions of the Paperwork Reduction Act.
**DATES:**
Consideration will be given to all comments received by September 21, 2022.
**ADDRESSES:**
Written comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice to *www.reginfo.gov/public/do/PRAMain.* Find this particular information collection by selecting “Currently under 30-day Review—Open for Public Comments” or by using the search function.
**FOR FURTHER INFORMATION CONTACT:**
Angela Duncan, 571-372-7574, *[email protected].*
**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.
*Type of Request:* Extension.
*Number of Respondents:* 258,899.
*Responses per Respondent:* 2.
*Annual Responses:* 517,798.
*Average Burden per Response:* 15 minutes.
*Annual Burden Hours:* 129,449.5.
*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.
*Frequency:* On occasion.
*Respondent's Obligation:* Voluntary.
*OMB Desk Officer:* Mr. Michael Ciccarone.
You may also submit comments and recommendations, identified by Docket ID number and title, by the following method:
• *Federal eRulemaking Portal: http://www.regulations.gov.* Follow the instructions for submitting comments.
*Instructions:* All submissions received must include the agency name, Docket ID 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 *http://www.regulations.gov* as they are received without change, including any personal identifiers or contact information.
*DOD Clearance Officer:* Ms. Angela Duncan.
Requests for copies of the information collection proposal should be sent to Ms. Duncan at *[email protected].*
Dated: August 16, 2022.
Kayyonne T. Marston,
Alternate OSD Federal Register Liaison Officer, Department of Defense.