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G. Premiums
1. Rates:
a. General. Premium rates are established by the Assistant Secretary of Defense (Health Affairs) for two rate groups— individual and family. The rates are based on Federal Employee Health Benefit Program employee and agency contributions which would be required for a comparable health benefits plan, plus an administrative fee. The administrative fee, which is not to exceed ten percent of the basic premium amount, is determined based on actual expected administrative costs for administration of the CHCBP. The premium rates may be updated annually and will be published when updated. The rates are also available from Humana Military. 
b. Rate Groups. Members discharged or released from active duty or full-time National Guard duty must select their rate group at the time they enroll—either individual or family. (All other CHCBP enrollees must select the individual option.) 
c. Changing Rate Groups. Only the former service member is eligible to change rate groups.
(1) Family to Individual. After enrollment, the sponsor may change from family to individual at any time by notifying Humana Military in writing. 
(2) Individual to Family. Changes from individual to family may not be made by the sponsor except when one of the following qualifying events has occurred:
(a) Birth of a child
(b) Marriage of the beneficiary
(c) Legal adoption of a child
(d) Placement by a court of a child as a legal ward in the service member’s home
(3) If one of the above qualifying events has occurred, the sponsor can change his/her enrollment from individual to family, effective as of the date of the qualifying event, if:
(a) The qualifying event occurred after the beneficiary’s enrollment in the CHCBP;
(b) The beneficiary sends a written request to Humana Military no later than sixty days from the date of the qualifying event (date of birth, date of marriage, etc.);
(c) The written request includes documentation of the qualifying event (a copy of the birth certificate, etc.) and the necessary additional premium. Premiums are to be prorated based on the days of each type of coverage.
(4) Payments
(a) Frequency. Premiums are to be paid quarterly by check, money order, or credit card to Humana Military. Payment must be made no later than 30 days after the start of the quarter.
(b) Failure to Make Payments. Failure by enrollees to make a premium payment will result in denial of continued enrollment in the CHCBP and denial of payment of medical claims for services provided on or after the first day of the quarter for which the premium payment was not paid. Beneficiaries denied continued enrollment due to lack of premium payments will not be allowed to re-enroll.


Last Reviewed:  May 14, 2007