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Military Health Care: Cost Data Indicate That TRICARE Reserve Select Premiums Exceeded the Costs of Providing Program Benefits

GAO-08-104 Published: Dec 21, 2007. Publicly Released: Dec 21, 2007.
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Highlights

(DOD) TRICARE Reserve Select (TRS) program allows most reservists to purchase coverage under TRICARE, the military health insurance program, when not on active duty. DOD intends to set premiums at a level equal to the expected costs of providing TRS benefits. The National Defense Authorization Act for 2007 required GAO to review TRS costs. As discussed with the committees of jurisdiction, GAO compared (1) the TRS premiums established by DOD to the reported costs of providing benefits under TRS in 2006 and (2) DOD's projected costs for TRS before implementation to DOD's reported costs for the program in 2005 and 2006. To do this work, GAO examined DOD analyses and interviewed DOD officials and external experts.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense With the goal of eventually eliminating reliance on BCBS premiums and to better align premiums with the costs of providing TRS health care benefits, the Secretary of Defense should direct the Assistant Secretary for Health Affairs to stop basing TRS premium adjustments only on BCBS premium adjustments and use the reported costs of providing benefits through the TRS program when adjusting TRS premiums in future years as limitations associated with the reported cost data decrease.
Closed – Not Implemented
Section 704 of the FY 2009 National Defense Authorization Act specifically identifies the manner in which the TRICARE Reserve Select premium will be calculated. The authority to adjust premiums no longer resides with TMA.
Department of Defense DOD should explore options for addressing instances in which premiums have been either significantly higher or lower than program costs in prior years, including seeking legislative authority as necessary.
Closed – Not Implemented
Section 704 of the FY 2009 National Defense Authorization Act specifically identities the manner in which the TRICARE Reserve Select premium will be calculated. The authority to adjust premiums no longer resides with TMA.

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Topics

Cost analysisHealth care costsHealth care programsHealth insuranceHealth insurance cost controlInsurance premiumsMilitary benefits claimsMilitary health servicesProgram managementBenefit-cost trackingCost estimatesProgram costsProgram goals or objectives