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TRICARE Supplement Plan
CrawfordAdvisors, LLC
Consulting, Brokerage & Administration
American Military
Retirees Association
(AMRA)
TRICARE Supplement Plan
CrawfordAdvisors, LLC
Consulting, Brokerage & Administration
American Military
Retirees Association
(AMRA)
Patrick C. Haynes, Jr.
As counsel for Crawford Advisors’ Employee Benefits and Executive Compensation Group,
Mr. Haynes advises employers and plan sponsors in a variety of health and welfare benefit plan
compliance matters, including, but not limited to, tax qualification and other Internal Revenue Code
issues, ERISA, COBRA and HIPAA portability and privacy issues. Mr. Haynes lectures frequently and
has published many articles on health and welfare benefit plan compliance topics.
Practice Areas
Employee Benefits & Exec Comp, ERISA, COBRA, HIPAA, §125, and §§ 105, 106, 129, 132
Education
Temple University School of Law, LL.M.
Rutgers University School of Law, J.D.
Rutgers University School of Business, M.B.A.
Rutgers University College of Arts & Sciences, B.A.
Admitted to Practice
U.S. Supreme Court
Federal and State Courts of
New Jersey
Pennsylvania
Connecticut
District of Columbia
200 International Circle, Suite 4500
Hunt Valley, MD 21031
555 East Lancaster Ave, Suite 640
Radnor, PA 19087
1.800.451.8519
www.Crawfordadvisors.com
Fayton Washington
As the Business and Development and Marketing Manager for ASI, Association and Society Insurance
Corporation, Mr. Washington travels the country meeting with employers and benefit specialists from
various industries and backgrounds training them on rules, regulations, and implementation of the
Corporate TRICARE Supplement Plan. He works with over 400 corporate accounts, helping employer
groups meet the needs of their employees and improving their overall bottom-line.
Education
University of South Carolina, B.A.
University of South Carolina, M.B.A.
2301 Research Blvd Ste 300.
Rockville, MD 20850
800-638-2610
www.asicorporation.com
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Agenda
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About TRICARE… “A Description”
Who is Eligible for the Supplement Plan?
Brief Overview of the Supplement Plan
TRICARE Supplement “The Options”
Premium Cost Monthly “Pre-Tax”
Administration of the Supplement Plan
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The Corporate TRICARE Supplement is a voluntary plan designated for companies that employ the military retiree community.
This voluntary supplemental health benefit is an option available to employees and their dependents who are eligible for TRICARE.
Eligible employees who enroll in the plan are responsible for 100% of the monthly premium amounts. Monthly premium payments are made with pre-tax dollars through payroll deduction.
Client groups include many of the top ten defense contractors, as well as professional, social, fraternal, military and trade associations. We also work with municipalities, federal credit unions and financial institutions from all over the United States.
Brief Overview
Eligible Employees
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These eligible individuals must be registered in the Defense Enrollment Eligibility
Reporting System (DEERS)(DEERS is a worldwide, computerized database of uniformed services members, their family
members and others who are eligible for military benefits)
Are under age 65 and retired from any branch of the armed
services (Army, Navy, Marines Corp, Air Force, Coast Guard,
Public Health Service or National Oceanic and Atmospheric
Administration (NOAA))
Military retirees entitled to retired, retainer or equivalent pay
2 TRICARE Retired Reserve under age 60 (“Gray Area” retirees)
3 Spouses and surviving spouses of retired Military personnel
4 Retired reservists over age 60 with at least 20 years of military service
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Eligible dependents are covered up to age 21 or 23 if a full-time
student
Incapacitated dependents are covered past age 21 or 23 if primarily
dependent on the member for support and continue TRICARE
eligibility.
Not subject to Health Care Reform.
The Patient Protection and Affordable Care Act (Public Law 111-148) did not give the DOD the
authority to offer this benefit through TRICARE.
However, H.R.4923: TRICARE Dependent Coverage Extension Act was introduced on March
24, 2010. This act is to extend TRICARE coverage to certain dependents under the age of 26.
According to the DOD, if enacted into law, they will make every effort to implement its
provisions as soon as possible.
This bill never became law. This bill was proposed in a previous session of Congress. Sessions of Congress last two years, and at the
end of each session all proposed bills and resolutions that haven't passed are cleared from the books. Members often reintroduce bills
that did not come up for debate under a new number in the next session.
Dependent Eligibility Age
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Employees and spouses who are over age 65 are eligible to enroll
in the TRICARE Supplement Plan, if they:
Reside inside or outside the U.S. or its territories
(these individuals must be enrolled in Medicare Part B and
eligible for Medicare Part A)
Are not eligible for Medicare
(these individuals must have received a Statement of
Disallowance from Social Security Administration and their
DEERS files must be updated)
Exceptions to the Age 65 Eligibility Rule
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INDEMNITY- FEE-FOR-SERVICE PLAN
Features of TRICARE Standard
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No enrollment required or enrollment fee to pay
Flexibility and freedom of choice when selecting a civilian provider
(inpatient or outpatient)
Access to Military Treatment Facility (MTF) on a space available
basis
No referral required
Provides worldwide access to healthcare
Works with TRICARE Extra
Pays all but the 25% cost share and excess charges after the
Outpatient Deductible ($150 per person/$300 per family) is met
Features of TRICARE Extra
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No enrollment required or enrollment fee to pay
Flexibility and freedom of choice when selecting a civilian
network provider (inpatient or outpatient)
Access to Military Treatment Facility on a space available basis
No referral required
Only available in the United States
Works with TRICARE Extra
Pays all but the 20% cost share after the Outpatient Deductible
($150 per person/$300 per family) is met
PREFERRED PROVIDER ORGANIZATION
Features of the TRICARE Supplement Plan
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Eligible employees may opt out of employer’s provided Group
Health Plan which reduces the employer’s healthcare cost
No pre-existing condition limitation
Guaranteed issue
Helps to provide greater access to civilian providers worldwide
Helps to pay the portion of the covered expenses that retirees
and eligible family members are responsible for paying
Covers the balance of eligible billed charges that are covered by
TRICARE after the Plan Deductible has been met
Portability, if coverage ends for any reason, employees can keep
the plan
TRICARE Standard
TRICARE Supplement
TRICARE Extra
TRICARE Supplement
Enrollment Fee N/A
Outpatient Deductible
$150 per person/$300 per
family
Pays 100% deductible
$150 per person/$300 per
family
Pays 100% deductible
Copayment None
Cost Share Pays 75% Allowed charge
Pays 25% cost share
Pays 80% negotiated cost
Pays your 20% cost share
Excess Charges Does not pay excess charge
Pays 100% excess charges up to Legal Limit
N/A
Prescription Civilian Network or TRICARE Mail Order
Pays all but $3/$9/$22 copayment
Pays copayments ($3/$9/$22)
Pays all but $3/$9/$22 copayment
Pays copayments ($3/$9/$22)
Prescription Civilian Non-Network
Pays all but deductible & $9/20% or $22/20%
Pays deductible plus $9/20% or $22/20%
N/A
Covered Expenses are subject to fiscal year Plan Deductible of $100 per person or $200 per family
How the Supplement Plan works with Standard/Extra
Employee Only $60.00
Employee plus Spouse $119.00
Employee plus Child (ren) $119.00
Employee plus Family $160.00
TRICARE Supplement Annual Deductible $100/individual and $200/family
Employees may use pre-tax dollars to pay premiums
Monthly Premium Amounts
American Military Retirees Association (AMRA): a non-
profit corporation with National Headquarters located in
Plattsburgh, New York. AMRA was incorporated in 1973
in New York State by and for all military retirees of the
United States Armed Forces.
Included in the monthly premium rates is $1.00 for the
AMRA association dues. This amount is deducted and
paid to AMRA on a monthly basis.
Plan Sponsor
Monumental Life Insurance Company
Cedar Rapids, IA
Transamerica Financial Life Insurance Company
Harrison, NY
AEGON companies
AEGON is one of the world’s leading life insurance and
pension organizations and a provider of investment
products, with businesses in over 20 markets in the
Americas, Europe and Asia.
Plan Underwriter
Questions
Crawford Advisors, LLC
• 200 International Circle, Suite 4500, Hunt Valley, MD 21031
• 555 East Lancaster Ave, Suite 640, Radnor, PA 19087
• 800.451.8519
• www.CrawfordAdvisors.com
Via E-mail to: [email protected]
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