July29 2010 by HC120730001433

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									    TRICARE SOUTH
RESERVE/GUARD ADVISORY
  COMMITTEE MEETING
       July 29, 2010
                      Overview

• Opening Comments

• Items From Last Meeting

• TRICARE Reserve Select and TRICARE Retired Reserve

• What T-3 Contracts Mean to You

• TRICARE Pharmacy Home Delivery

• Extension of the TRICARE Early Eligibility Program

• Feedback from the Field

• Closing Comments
                                                       2
Item(s) From Last Meeting (21 Jan 2010)

        Ms. Sherry Steindel, RC BCAC
        TRICARE Regional Office-South




                                          3
TRICARE Reserve Select and TRICARE
  Retired Reserve Program Overview

            Mr. Mac Sanders
           Ms. Sherry Steindel
                RC BCAC
      TRICARE Regional Office-South


                                      4
               South Region TRS Enrollment
              Trends: By Reserve Component
7000

6000
                                                                                                     Army National Guard
5000
                                                                                                     Air National Guard
4000                                                                                                 Army Reserve
                                                                                                     Navy Reserve
3000
                                                                                                     Air Force Reserve
2000                                                                                                 Marine Reserve
                                                                                                     Coast Guard Reserve
1000

   0
           Jan-10        Feb-10      Mar-10       Apr-10          May-10            Jun-10
                                   Jan 10     Feb 10       Mar 10          Apr 10        May 10      Jun 10

   Army National Guard              5862       5961        6202            6,485             6,602    6,505
   Air National Guard               1965       1983        1971            2,012             2,052    2,058
   Army Reserve                     4325       4379        4497            4,721             4,816    4,823
   Navy Reserve                     2062       2073        2113            2,228             2,279    2,310
   Air Force Reserve                2234       2292        2298            2,385             2,371    2,386
   Marine Reserve                    667        678         687             730               753      734
   Coast Guard Reserve               388        388         395             399               362      351
   TOTAL                           17,503     17,754       18,163          18,960        19,235      19,167

                         http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
                                     Source: DEERS Data as of July 20,2010                                                 5
              South Region TRS Enrollment
         Trends: National Guard by State
1800
1600
1400                                                                                                        Jan-10
1200                                                                                                        Feb-10
1000
                                                                                                            Mar-10
 800
                                                                                                            Apr-10
 600
 400                                                                                                        May-10
 200                                                                                                        Jun-10
   0
         AL        AR        FL       GA        LA        MS        OK        SC            TN      TX
                                    National Guard TRS Enrollment By State
                         Jan-10       Feb-10        Mar-10       Apr-10            May-10        Jun-10
              AL           795          807          824           876              871            853
              AR           732          732          736           754              769            769
              FL           710          755          773           824              857            885
              GA           739          711          728           783              791            785
              LA           703          739          754           781              740            642
              MS           599          626          631           647              635            641
              OK           796          816          852           871              873            845
              SC           776          784          808           762              768            767
              TN           734          727          745           771              818            849
              TX          1243         1247          1322         1428              1532          1527
                          http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
                                 Source: DEERS Data as of July 20,2010                                               6
       POC TRICARE Regional Office South, Sherry Steindel, 210-292-3216, sherry.steindel@tros.tma.osd.mil
        TRICARE Retired Reserve (TRR)
             (Gray-Area Retirees)
• Contrasted with TRICARE Reserve Select (TRS)
• Retired Reservists may qualify to purchase TRICARE coverage
  - Qualified for non-regular retirement at age 60, but is not yet age 60
• Commonly called gray-area retirees
   - Not enrolled or eligible to enroll in Federal Health Employees
      Benefits (FEHB) program
• TRR premiums equal full cost of premium by law
   - TRR – premiums are not subsidized
   - TRS – premium rates reflect 28% of total TRS premium costs
• TRICARE Standard/Extra comprehensive coverage
   for a) member-only or b) member and immediate family
   - TRR: retiree cost shares, deductibles, and catastrophic cap apply
   - TRS: active duty family member cost shares, deductibles, and
      catastrophic cap apply
• Statute requires DoD to prescribe federal regulations
                 Section 705, NDAA for FY 2010
                                                                            7
             Issues With Current
                Contingencies
• Deep Water Horizon Operations
     Weekly Contact With Key Players
     Problematic “Less Than 30 Days” Orders
     Working “Behind the Scene” on Family Member Enrollments
     Title 10 vs Title 32 Orders

• Re-enrollment in TRS
     If member elects to have TRS the member must re-enroll




                                                               8
 New TRICARE Contract and
   What It Means to You
           (Update on T-3)


Ms. Martha Lupo, Chief Operating Officer
    TRICARE Regional Office-South



                                           9
                              TRICARE PHARMACY
                                  HOME DELIVERY
                                               Hector Morales
                                               Deputy Director
                                TMA Pharmacy Operations Center




DoD Pharmacoeconomic Center                                      10
www.pec.ha.osd.mil
                     TOTAL PHARMACY EXPENDITURE
                                            FY09




DoD Pharmacoeconomic Center                        11
www.pec.ha.osd.mil
                        TOTAL AVERAGE COST PER RX




DoD Pharmacoeconomic Center
www.pec.ha.osd.mil                                  12
                                             POS Expenditures and Utilization
                                                           April 09 – May 10
              Expenditures in                                           30 day equiv in
              millions                                                  millions
           140                                                    5.0
           120                                                    4.0
           100
            80                                                ACE 3.0                                                ACE
Millions




                                                              ARB 2.0                                                ARB
            60
                                                              DRI                                                    DRI
            40                                                    1.0
            20
                                                                    0
             0                                                            Mail Order     MTF        Retail
                    Mail Order     MTF      Retail
                      Mail Order   MTF     Retail    All POS                    Mail Order   MTF   Retail    All POS

            ACE          19.2       29.7   40.7       89.6              ACE        1.6       3.9    3.0        8.6
            ARB          46.7       41.2   126.0      213.9             ARB        1.5       2.1    1.9        5.5
            DRI          1.8       461K     5.4        7.7              DRI        44K       22K    70K       135K
            Total        67.8       71.4   172.1      311.2             Total      3.2       6.1    5.1       14.2



              DoD Pharmacoeconomic Center                         Not VARR corrected
              www.pec.ha.osd.mil
                                                                  Source: PDTS                                         13
                                        ESI’S MEMBER
                                       CHOICE CENTER
                                           877-363-1433
         • CONVENIENT

        • SAVINGS ($3, $9 & $22 per 90 days)

        • EASY START UP

        • 10-14 DAYS FOR ARRIVAL

        • Not available if member has other health insurance




DoD Pharmacoeconomic Center
www.pec.ha.osd.mil                                             14
                                                         ACCESS


                • Talk to a pharmacist 24 hours a day,
                  7 days a week

                 • Access to prescriptions, even when traveling




DoD Pharmacoeconomic Center
www.pec.ha.osd.mil                                                15
                                                                                      REFILL PROCESS


                          • 66% Utilization Rule




http://tricare.mil/mybenefit/home/Prescriptions/FillingPrescriptions/TMOP/Register?



                               • Sign up for automatic refills
                               • Online access to mail order account,
                                 with ability to order refills
     DoD Pharmacoeconomic Center                                                                       16
     www.pec.ha.osd.mil
              Formulary Search Tool




                                        COPAY’S AT
                                        MAIL ORDER
                                      • $3 Generics

                                      • $9 Formulary Brand

                                      • $22 Non-Formulary
                                      Drugs




DoD Pharmacoeconomic Center
                                                        17
www.pec.ha.osd.mil
                              DRUG LOOK UP




DoD Pharmacoeconomic Center                  18
www.pec.ha.osd.mil
                              PEC WEBSITE/DPP FOR
                                 SERVICE MEMBERS




DoD Pharmacoeconomic Center                         19
www.pec.ha.osd.mil
                              Questions?




DoD Pharmacoeconomic Center                20
www.pec.ha.osd.mil
    Early Identification for TRICARE Eligibility
                        (EID)

                 Mr. Mike Boyle
                Mr. Dave Percich
               OSD Reserve Affairs



OASD (RA)
OASD (RA)                                          21
            Early Identification for TRICARE Eligibility (EID)


 •Initial EID
       •Section 1116 of Emergency Supplemental Appropriations Act for Defense and for the Reconstruction of Iraq
       and Afghanistan, 2004, amended section 1074 of 10 U.S.C. establishing early TRICARE eligibility for RC
       members issued delayed-effective-date active-duty orders for more that 30 days in support of a contingency
       operation
       •Initially authorized up to 90 days of early TRICARE coverage for RC members, and their families
       •Effective November 6, 2003, subsequent amendments make this benefit permanent


 •EID Reporting by Reserve Components
       •Reserve components identify eligibility in the Reserve Components Common Personnel Data System
       (“RCCPDS”)
       •DMDC processing of EID transactions from RCCPDS to DEERS


 •Expanded EID
       •Section 702 of 2010 NDAA expanded early TRICARE coverage for up to 180 days
       •Effective October 28, 2009
       •Retroactive TRICARE coverage for EID authorized for members notified of mobilization (issued delayed-
       effective-date active-duty order) by October 28, 2009
       •Expanded EID coverage will take effect upon publication on the WHS Directive Web site


OASD (RA)
OASD (RA)                                                                                                           22
            Early Identification for TRICARE Eligibility (EID)


                                  Delayed-Effective-Date Active-Duty Order

        An official document prescribing the order to active duty of a RC member or members on a specified date
   after the date of issuance of the order for a period of more than 30 days in support of a contingency operation
   as defined in section 101(a)(13)(B) of Reference (e)). Such an order may be either an individual mobilization
   order or a unit mobilization order provided it specifies an order authority, a start date, and the duration of the
   activation. To qualify, the unit mobilization order shall apply to all unit members or have an annex, approved
   by a senior authorized individual for the unit or higher headquarters, identifying all individuals to whom
   individual mobilization orders will be issued.




OASD (RA)
OASD (RA)                                                                                                               23
Feedback From the Field

      Open Discussion




                          24
     Closing Comments

    Mr. William Thresher, Director
   TRICARE Regional Office-South

Mr. Larry Burchfield, Senior Executive
Humana Military Healthcare Services



                                         25

								
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