TRICARE SOUTH RESERVE/GUARD ADVISORY COMMITTEE MEETING

1. TRICARE SOUTH RESERVE/GUARD ADVISORY COMMITTEE MEETING April 12, 2011

2. Overview • Opening Comments • Items From Last Meeting • TRICARE Reserve Select and TRICARE Retired Reserve • New TRICARE Programs • What T-3 Contracts Mean to You • TRO-South Support for Mobilizing/Demobilizing RC Units • Maximizing Humana Military's Briefing Support • TRO-South Support During Contingencies • Feedback from the Field • Closing Comments 2

3. Mr. Mac Sanders Customer Service Representative TRICARE Regional Office - South Items From Last Meeting (July 29, 2010) 3

4. Items From Last Meeting (July 29, 2010) • TRICARE Eligibility and Federal Employee Health Benefits Program • Claim Resolution Issues • Members not aware of active duty benefit implementation • Link TRICARE Pharmacy Home Delivery site to Air Force Reserve Web site 4 billy.sanders@tros.tma.osd.mil

5. Air Force Reserve Command (AFRC) Home Delivery (HD) Mail Order Outreach • Partnership established between AFRC and TRO South to support TMA’s strategic objective to encourage use of HD, when medically appropriate. • Concept: Leverage AFRC’s Human Resource (HR) Web Portal to disseminate HD education material to AF Reservists/National Guardsmen. • Coordination with and support gained from Chair, TMA HD Committee to provide HD educational products to AFRC. • TMA and TRO South awaiting AFRC’s Phased plan to determine processes used to capitalize on the distribution of HD material on the HR Web Portal. 5 John.felico@tros.tma.osd.mil

6. TRICARE Reserve Select and TRICARE Retired Reserve Program Overview Ms. Sherry Steindel RC BCAC, TRICARE Regional Office - South 6

7. South Region TRS Enrollment Trends: By Reserve Component http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm 7 Source: DEERS Data as of March 24, 2011 sherry.steindel@tros.tma.osd.mil

8. South Region TRS Enrollment Trends: National Guard by State http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm Source: DEERS Data as of March 24, 2011 8 sherry.steindel@tros.tma.osd.mil

9. Puerto Rico TRS Enrollment Trend: Reserve Component Feb 11 http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm Source: DEERS Data as of March 24, 2011 9 sherry.steindel@tros.tma.osd.mil

10. South Region TRR Enrollment Trends: By Reserve Component http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm Source: DEERS Data as of March 25, 2011 10 sherry.steindel@tros.tma.osd.mil

11. New TRICARE Programs Mr. Bill Prevo Network Operations, TRICARE Regional Office - South 11

12. TRICARE Young Adult Program (TYA) • TRICARE Prime, Standard/Extra benefit with applicable co-payments, deductibles and cost shares for unmarried dependents • Full premium based program available worldwide • Current premiums not yet established • Eligible for care in military treatment facilities (MTFs) according to access priority of sponsor • Not authorized for those eligible to enroll in employer sponsored health insurance plan • Phased implementation • TRICARE Standard/Extra retroactive to 1 Jan 2011 beginning 1 May 2011 • TRICARE Prime enrollment October 2011 • Enrollment Projections for South Region • 77,861 eligible, 7,565 initial enrolled increasing to 21,615 by 2015 • Approximately 1,300 enrolled in CHCBP will convert to TYA if eligible 12 william.prevo@tros.tma.osd.mil

13. Enrollment Portabilityfor ADSMs and ADFMs • “Movement Made Easy for Active Duty Family Members” • Designed to simplify and expedite PCM changes for PCS moves • Includes overseas transfers • Allows verbal notification to losing MCSC of upcoming transfer without visiting MTF/TSC • Losing MCSC emails transfer info to gaining MCSC daily • Retains current PCM enroute • Referral/Auth for non-urgent care still required • Gaining MCSC contacts family within 5 days of date of relocation to obtain additional information to complete PCM change to new region • PCM change form required if signed ATC waiver is required 13 william.prevo@tros.tma.osd.mil

14. New TRICARE Contract and What It Means to You (Update on T-3) Ms. Martha Lupo Chief Operating Officer, TRICARE Regional Office - South 14

15. T-3 Managed Care Support Contracts • New Managed Care Support Contractors Selected • Current Awardees: HealthNet, Humana, TriWest (red = under protest) • North Region started health care delivery under T3 on 1 April 11 • South Region target start date is 1 April 12 • West Region will start after the South • Minimum 10-month transition period • Current contractors continue care in interim • No significant change in covered services in T3 • T3 improves focus on preventive health, case management, quality outcomes, coordination of care, and consistent communication 15 Martha.lupo@tros.tma.osd.mil

16. Enhanced RC Outreach Mr. Mac Sanders Customer Service Representative, TRICARE Regional Office - South 16

17. Overview Objectives Outreach Strategies Detailed Actions 17 Billy.sanders@tros.tma.osd.mil

18. Strategy • Coordinate with all pertinent parties to: • Ensure accurate TRICARE benefit information provided to Reserve Component (RC) members and their families • During early eligibility period and deployment • During demobilization and transitional assistance management program (TAMP). 18 Billy.sanders@tros.tma.osd.mil

19. Enhanced Outreach Objectives • Ensure RC beneficiaries have up-to-date TRICARE information • Humana Military provides TRICARE briefings during all Yellow Ribbon events • Emphasize access to care for member and family • Utilizing personnel listing with address provided by the unit • Provide mapping of where the member/family reside • Provide physician (network/non-network) in all zip codes where families reside • Meet with unit personnel to discuss findings • Maintain constant contact with unit commander, rear detachment leadership, or TRICARE liaison as appropriate • Ensure TRICARE issues are addressed as they occur. 19 Billy.sanders@tros.tma.osd.mil

20. Current Outreach • Quarterly RC telephone conferences • All health benefits advisor RC personnel invited • Subject matter experts speaking on relevant issues • Share success stories • TRICARE BCAC & Communications Partnership meetings • Post Card Mail-outs • TRICARE email blasts • Direct2U • TRO-South RC Web site http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm 20 Billy.sanders@tros.tma.osd.mil

21. TRICARE Support to the 53rd Infantry Brigade Combat Team Mr. Ray Sanchez Chief Program Operations Division, TRICARE Regional Office - South 21

22. Demobilization Preparation On 9 Nov 10, a Working Group met with reps from: TRO-South Humana Military Healthcare Services Value Options Florida State Surgeon’s Office 53rd IBCT (National Guard, Florida) Winn Army Community Hospital Goal to develop a plan for an effective medical referral process for redeploying Soldiers and to sign up the maximum number of Soldiers for TAMP Prime. 22 Ramon.sanchez@tros.tma.osd.mil

23. Process Changes Same day processing for all referrals to receive care at home. - Behavioral Health: Soldiers departed Fort Stewart with date, time and name of BH provider they would see at home (Value Options). - Other Medical: Soldiers departed Fort Stewart with authorizations in hand (name and contact information for specific provider). 23 Ramon.sanchez@tros.tma.osd.mil

24. Results 457 ADSM = 770 Referrals (80 BH) – 764 subsequent referrals Appointments made for all Behavioral Health referrals 550 TAMP enrollment forms completed 457 tracked by Warrior Navigation Assistance Program (WNAP) (30, 60 and 90 day intervals) 24 Ramon.sanchez@tros.tma.osd.mil

25. Future Behavioral Health Support Deployment or Redeployments • TRICARE Behavioral Health Care Provider Locator and Appointment Assistance Line was discontinued on 31 March 2011. • Behavioral Health referrals to be accomplished like physical medicine referrals, authorization and provider information given • No appointments made 25 Ramon.sanchez@tros.tma.osd.mil

26. Maximizing Humana Military’s Briefing Support Mr. Wendell Cheek, Director Guard and Reserve Programs, Humana Military Healthcare Services 26

27. Maximizing Humana Military’s Briefing Support • BRIEFING TIME VS. BOOTH ONLY • BENEFITS OF A 30 MINUTE BRIEFING • ALLOWS CREDIBILITY WITH AUDIENCE • UPDATED INFORMATION • EVERYONE HEARS THE BRIEFING • STIMULATES DISCUSSION • ALLOWS FOR QUESTION AND ANSWER • MORE FOCUSED ON THE TARGET AUDIENCE • BENEFICIARY BECOMES MORE KNOWLEDGEABLE • LEADS TO ONE-ON-ONE DISCUSSIONS • OPPORTUNITY TO PLUG TRS • SLIDES HELP SM AND FAMILIES TO RETAIN INF0RMATION 27

28. Maximizing Humana Military’s Briefing Support • BENEFITS OF BOOTH ONLY • ALLOWS FOR ONE-0N-ONE PERSONAL DISCUSSION • INDIVIDUAL SM OR FAMILY MEMBER GAINS KNOWLEDGE BEST OPTION IS BRIEFING AND BOOTH/INFORMATION TABLE 28

29. TRO-South Support During Contingencies LT William Chew Coast Guard Liaison Officer, TRICARE Regional Office - South 29

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31. 2011 Hurricane Season Hurricane Season begins 1 June through 30 November, peak season exists from mid-August to late October 31 william.chew@tros.tma.osd.mil Source: http://www.weatheradvance.com

32. TRO-S Contingency Support Activities • Generate TMA Primary Care waivers for referrals • Eliminates point of service fees • MTF/TRO initiate in collaboration with MCSC • Pharmacy and Dental waivers • End Automatic Disenrollment of Beneficiaries due to non-payment • Communication: provide updated information and outreach to beneficiaries, (webpage and printed informational materials, mail postcards, visit evacuation shelters, and toll-free numbers) • Resource Sharing Opportunities • Increase awareness of Stakeholder Participation ( Contingency Exercises) • Increase awareness of MTF, Humana Military, and TROS • Value: rapid response to contingency events • Established communication with waiver granting authorizes • Collaboration and team work • Lessons learned locally transferred throughout the region • Recent Events: 116 contingency exercises completed last year with the MCSC and 45 MTFs • Monitored 4 hurricanes and 6 Tropical Storms • Tracked and supported Haitian earthquake patient evacuees • Supported Deepwater Horizon Gulf oil spill disaster • Assisted with relocation and waiver approval from TN floods affecting Millington, Nashville and Knoxville • Monitored OK wildfires affecting statewide Emergency Prescription Refill authorizations • Engaged with ongoing support of Japan and Bahrain evacuation relief efforts 32 william.chew@tros.tma.osd.mil

33. Contingency Support for National Guard and Reservists • Activated Service members under Federal orders for contingency • Various search and rescue, command and control and evacuation missions following hurricanes and other disasters • Activated Service members displaced from duties at contingency site • TRS enrollees • Deep Water Horizon Gulf Oil Spill • Targeted TRICARE Briefings and Prime Enrollment support 33 william.chew@tros.tma.osd.mil

34. Open Discussion Feedback From the Field 34

35. Questions ? 35

36. Mr. William Thresher, Director, TRICARE Regional Office - South Mr. Larry Burchfield, Senior Executive, Humana Military Healthcare Services Closing Comments 36