Directs the Secretary of the military department concerned to pay the applicable premium to continue in force any qualified health plan coverage for a reserve member (and his or her dependents) while the member is serving on active duty pursuant to a call or order issued during a war or national emergency declared by the President or Congress. Requires the continuation of COBRA coverage during such period. Prohibits simultaneous coverage under both the qualified health plan and TRICARE.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 852 Introduced in Senate (IS)]
108th CONGRESS
1st Session
S. 852
To amend title 10, United States Code, to provide limited TRICARE
program eligibility for members of the Ready Reserve of the Armed
Forces, to provide financial support for continuation of health
insurance for mobilized members of reserve components of the Armed
Forces, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 10, 2003
Mr. DeWine (for himself, Mr. Daschle, Mr. Smith, and Mr. Leahy)
introduced the following bill; which was read twice and referred to the
Committee on Armed Services
_______________________________________________________________________
A BILL
To amend title 10, United States Code, to provide limited TRICARE
program eligibility for members of the Ready Reserve of the Armed
Forces, to provide financial support for continuation of health
insurance for mobilized members of reserve components of the Armed
Forces, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``National Guard and Reserve
Comprehensive Health Benefits Act of 2003''.
SEC. 2. TRICARE COVERAGE FOR MEMBERS OF THE READY RESERVE.
(a) Eligibility.--(1) Chapter 55 of title 10, United States Code,
is amended by inserting after section 1076a the following new section:
``Sec. 1076b. TRICARE program: coverage for members of the Ready
Reserve
``(a) Eligibility.--Members of the Selected Reserve of the Ready
Reserve and members of the Individual Ready Reserve described in
subsection 10144(b) of this title are eligible, subject to subsection
(h)(1), to enroll in the following TRICARE program options:
``(1) TRICARE Prime.
``(2) TRICARE Standard.
``(b) Types of Coverage.--(1) A member eligible under subsection
(a) may enroll for either of the following types of coverage:
``(A) Self alone coverage.
``(B) Self and family coverage.
``(2) An enrollment by a member for self and family covers the
member and the dependents of the member who are described in
subparagraph (A), (D), or (I) of section 1072(2) of this title.
``(c) Open Enrollment Periods.--The Secretary of Defense shall
provide for at least one open enrollment period each year. During an
open enrollment period, a member eligible under subsection (a) may
enroll in the TRICARE program or change or terminate an enrollment in
the TRICARE program.
``(d) Scope of Care.--(1) A member and the dependents of a member
enrolled in the TRICARE program under this section shall be entitled to
the same benefits under this chapter as a member of the uniformed
services on active duty or a dependent of such a member, respectively.
``(2) Section 1074(c) of this title shall apply with respect to a
member enrolled in the TRICARE program under this section.
``(e) Premiums.--(1) The Secretary of Defense shall charge premiums
for coverage pursuant to enrollments under this section. The Secretary
shall prescribe for each of the TRICARE program options referred to in
subsection (a) a premium for self alone coverage and a premium for self
and family coverage.
``(2) The monthly amount of the premium in effect for a month for a
type of coverage under this section shall be the amount equal to 28
percent of the total amount determined by the Secretary on an
appropriate actuarial basis as being reasonable for the coverage.
``(3) The premiums payable by a member under this subsection may be
deducted and withheld from basic pay payable to the member under
section 204 of title 37 or from compensation payable to the member
under section 206 of such title. The Secretary shall prescribe the
requirements and procedures applicable to the payment of premiums by
members not entitled to such basic pay or compensation.
``(4) Amounts collected as premiums under this subsection shall be
credited to the appropriation available for the Defense Health Program
Account under section 1100 of this title, shall be merged with sums in
such Account that are available for the fiscal year in which collected,
and shall be available under subsection (b) of such section for such
fiscal year.
``(f) Other Charges.--A person who receives health care pursuant to
an enrollment in a TRICARE program option under this section, including
a member who receives such health care, shall be subject to the same
deductibles, copayments, and other nonpremium charges for health care
as apply under this chapter for health care provided under the same
TRICARE program option to dependents described in subparagraph (A),
(D), or (I) of section 1072(2) of this title.
``(g) Termination of Enrollment.--(1) A member enrolled in the
TRICARE program under this section may terminate the enrollment only
during an open enrollment period provided under subsection (c), except
as provided in subsection (h)(2).
``(2) An enrollment of a member for self alone or for self and
family under this section shall terminate on the first day of the first
month beginning after the date on which the member ceases to be
eligible under subsection (a).
``(3) The enrollment of a member under this section may be
terminated on the basis of failure to pay the premium charged the
member under this section.
``(h) Relationship to Transition TRICARE Coverage Upon Separation
From Active Duty.--(1) A member may not enroll in the TRICARE program
under this section while entitled to transitional health care under
subsection (a) of section 1145 of this title or while authorized to
receive health care under subsection (c) of such section.
``(2) A member who enrolls in the TRICARE program under this
section within 90 days after the date of the termination of the
member's entitlement or eligibility to receive health care under
subsection (a) or (c) of section 1145 of this title may terminate the
enrollment at any time within one year after the date of the
enrollment.
``(i) Regulations.--The Secretary of Defense, in consultation with
the other administering Secretaries, shall prescribe regulations for
the administration of this section.''.
(2) The table of sections at the beginning of such chapter is
amended by inserting after the item relating to section 1076a the
following new item:
``1076b. TRICARE program: coverage for members of the Ready Reserve.''.
(b) Definitions.--(1) Section 1072 of title 10, United States Code,
is amended by adding at the end the following new paragraphs:
``(10) The term `TRICARE Prime' means the managed care
option of the TRICARE program.
``(11) The term `TRICARE Standard' means the option of the
TRICARE program that is also known as the Civilian Health and
Medical Program of the Uniformed Services''.
(2) Section 1097a(f) of such title is amended by striking
``Definitions.--In this section:'' and all that follows through ``(2)
The term'' and inserting ``Catchment Area Defined.--In this section,
the term''.
(c) Period for Implementation.--Section 1076b of title 10, United
States Code (as added by subsection (a)), shall apply with respect to
months that begin on or after the date that is 180 days after the date
of the enactment of this Act.
SEC. 3. ALLOWANCE FOR CONTINUATION OF NON-TRICARE HEALTH BENEFITS
COVERAGE FOR CERTAIN MOBILIZED RESERVES.
(a) Payment of Premiums.--(1) Chapter 55 of title 10, United States
Code, is amended by inserting after section 1078a the following new
section:
``Sec. 1078b. Continuation of non-TRICARE health benefits plan coverage
for certain Reserves called or ordered to active duty and
their dependents
``(a) Payment of Premiums.--The Secretary concerned shall pay the
applicable premium to continue in force any qualified health benefits
plan coverage for an eligible reserve component member for the benefits
coverage continuation period if timely elected by the member in
accordance with regulations prescribed under subsection (j).
``(b) Eligible Member.--A member of a reserve component is eligible
for payment of the applicable premium for continuation of qualified
health benefits plan coverage under subsection (a) while serving on
active duty pursuant to a call or order issued under a provision of law
referred to in section 101(a)(13)(B) of this title during a war or
national emergency declared by the President or Congress.
``(c) Qualified Health Benefits Plan Coverage.--For the purposes of
this section, health benefits plan coverage for a member called or
ordered to active duty is qualified health benefits plan coverage if--
``(1) the coverage was in force on the date on which the
Secretary notified the member that issuance of the call or
order was pending or, if no such notification was provided, the
date of the call or order;
``(2) on such date, the coverage applied to the member and
dependents of the member described in subparagraph (A), (D), or
(I) of section 1072(2) of this title; and
``(3) the coverage has not lapsed.
``(d) Applicable Premium.--The applicable premium payable under
this section for continuation of health benefits plan coverage in the
case of a member is the amount of the premium payable by the member for
the coverage of the member and dependents.
``(e) Maximum Amount.--The total amount that may be paid for the
applicable premium of a health benefits plan for a member under this
section in a fiscal year may not exceed the amount determined by
multiplying--
``(1) the sum of one plus the number of the member's
dependents covered by the health benefits plan, by
``(2) the per capita cost of providing TRICARE coverage and
benefits for dependents under this chapter for such fiscal
year, as determined by the Secretary of Defense.
``(f) Benefits Coverage Continuation Period.--The benefits coverage
continuation period under this section for qualified health benefits
plan coverage in the case of a member called or ordered to active duty
is the period that--
``(1) begins on the date of the call or order; and
``(2) ends on the earlier of the date on which--
``(A) the member's eligibility for transitional
health care under section 1145(a) of this title
terminates under paragraph (3) of such section; or
``(B) the member elects to terminate the continued
qualified health benefits plan coverage of the
dependents of the member.
``(g) Extension of Period of COBRA Coverage.--Notwithstanding any
other provision of law--
``(1) any period of coverage under a COBRA continuation
provision (as defined in section 9832(d)(1) of the Internal
Revenue Code of 1986) for a member under this section shall be
deemed to be equal to the benefits coverage continuation period
for such member under this section; and
``(2) with respect to the election of any period of
coverage under a COBRA continuation provision (as so defined),
rules similar to the rules under section 4980B(f)(5)(C) of such
Code shall apply.
``(h) Nonduplication of Benefits.--A dependent of a member who is
eligible for benefits under qualified health benefits plan coverage
paid on behalf of a member by the Secretary concerned under this
section is not eligible for benefits under the TRICARE program during a
period of the coverage for which so paid.
``(i) Revocability of Election.--A member who makes an election
under subsection (a) may revoke the election. Upon such a revocation,
the member's dependents shall become eligible for benefits under the
TRICARE program as provided for under this chapter.
``(j) Regulations.--The Secretary of Defense shall prescribe
regulations for carrying out this section. The regulations shall
include such requirements for making an election of payment of
applicable premiums as the Secretary considers appropriate.''.
(2) The table of sections at the beginning of such chapter is
amended by inserting after the item relating to section 1078a the
following new item:
``1078b. Continuation of non-TRICARE health benefits plan coverage for
certain Reserves called or ordered to
active duty and their dependents.''.
(b) Applicability.--Section 1078b of title 10, United States Code
(as added by subsection (a)), shall apply with respect to calls or
orders of members of reserve components of the Armed Forces to active
duty as described in subsection (b) of such section, that are issued by
the Secretary of a military department on or after the date of the
enactment of this Act.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S5177-5178)
Read twice and referred to the Committee on Armed Services.
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