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Testimony Time

MOAA and The Military Coalition address SBP, concurrent receipt, health care, force levels, and family issues in armed services committee hearings.

On April 5, Col. Steve Strobridge, USAF-Ret., director of MOAA’s Government Relations Department and cochairman of The Military Coalition (TMC), presented TMC testimony about personnel and compensation issues before the Senate Armed Services Personnel Subcommittee. Also testifying were Joyce Raezer of the National Military Family Association and Deirdre Holleman of The Retired Enlisted Association.

MOAA Testimony Highlights
* Increase Army and
Marine Corps staffing.

* Fix Survivor Benefit Plan inequities.

* Expand concurrent
receipt.

* Improve Reserve health care and retirement.

* Upgrade health care
access.

* Increase family support funding.

* Authorize flexible spending accounts.

In March, similar testimony was provided to the House Armed Services Military Personnel Subcommittee. A panel of DoD and service personnel leaders also testified at the same hearings.
Strobridge’s and the other TMC witnesses’ testimony highlighted the need for:

  • increased manpower levels for the Army and Marine Corps;
  • Survivor Benefit Plan (SBP) improvements (see “SBP Needs Cosponsors,” page 30);
  • further action on concurrent receipt to address significant remaining retired pay inequities for disabled retirees;
  • health coverage and retirement adjustments for all members of the Selected
    Reserve;
  • additional initiatives to improve beneficiary access to TRICARE-participating providers;
  • increased funding for military family support programs; and
  • implementation of the same health and dependent care tax-saving initiatives for military members that all federal civilians already enjoy.

Testimony by DoD and service personnel leaders focused on recruiting and retention issues—urging increases in bonuses and other lump-sum payments to meet recruiting and retention goals. Officials also downplayed the significance and severity of recruiting shortfalls, even while acknowledging that meeting recruiting goals continues to present a challenge, especially for the Guard and Reserve.

You can read the full TMC testimony on MOAA’s Web Base at www.moaa.org/legislative/testimony.

A Premium Moment

Warner, Davis push pre-tax health premium payments.

Why Deny Troops Pre-Tax Savings?
Flexible spending accounts and pre-tax premium payments offer hundreds or thousands of dollars in annual savings. A person in the 28-percent federal tax bracket with a 4 percent state income tax must earn $1,470 before income and payroll taxes to pay each $1,000 of covered expenses in post-tax money.
On March 3, MOAA President Vice Adm. Norbert R. Ryan Jr., USN-Ret., spoke at a Capitol Hill press conference held by Sen. John Warner (R-Va.) and Rep. Tom Davis (R-Va.). The event highlighted the reintroduction of Warner’s and Davis’ bills (S. 484 and H.R. 994, respectively) that would let retired servicemembers and survivors pay TRICARE Prime enrollment fees, TRICARE Standard supplemental insurance premiums, and TRICARE dental premiums with pre-tax dollars. This premium conversion plan deducts premiums from paychecks before federal and state income taxes are calculated. Federal employees have enjoyed this benefit since 2000. Employees of most large private sector firms can do so as well.

“Premium conversion … is an important benefit that must rightfully be extended to our annuitants, and I am proud to again take the lead on this important legislation,” said Davis.

“This is an equity issue,” Ryan added. “We are one team [civil service and military] with the same mission—service to the nation.”

To urge your senators and representative to cosponsor these bills, please visit MOAA’s Web site at http://capwiz.com/moaa/issues/bills. Click on the links to S. 484 and H.R. 994, (scroll down to “Health Care Issues”) and enter your ZIP code in the box.

MOAA also is actively seeking both premium conversion and flexible spending accounts (FSAs) for military servicemembers. Ninety percent of private sector employers, and more recently the federal civil service, allow their employees to pay dependent and health care expenses on a pre-tax basis. FSAs let employees set aside pre-tax money from every paycheck for those specific purposes. Exempting this money from federal and state income tax and Social Security and Medicare payroll taxes saves employees 20 percent to 40 percent or more, depending on tax rates.

DoD, however, has yet to keep pace with changing expectations of the workforce by implementing family-friendly services such as FSAs. If the Office of Personnel Management can offer FSAs to federal civilian employees, and virtually all large corporations can do so for millions of private sector employees nationwide, servicemembers should have the same options.

Given the tremendous personal and financial sacrifices servicemembers’ families are making in supporting their country, they deserve nothing less. As the largest employer in the country, it seems reasonable for DoD to get in step with the rest of the industry and the federal civilian workforce.

Key Issues Moving

Congress considers death benefits, VA funding, and Reserve tax credits.

Don’t Split Hairs on Death Benefits
MOAA agrees with service leaders’ testimony that the same survivor benefit rules should apply for all active duty deaths. Survivors whose sponsors died of service-connected causes are no less deserving if the death didn’t occur in combat.
On March, the House and Senate moved forward on legislative actions with significant implications for the military and veterans communities, as both chambers passed their respective versions of the FY 2006 Budget Resolution. The Senate version (S. Con. Res. 18) increased VA budget authority enough to eliminate any need to implement administration-proposed enrollment fees and pharmacy copayment increases for non-disabled, non-indigent veterans enrolled in VA health care. The House version (H. Con. Res. 95) added $297 million to the president’s budget request—but that’s less than the $424 million it would take to eliminate the proposed enrollment fees. During floor debate, Budget Committee members said other ways would be found to address the shortfall rather than imposing enrollment fees.

The Senate version of the Budget Resolution also included Sen. Mary Landrieu’s (D-La.) plan to provide significant tax credits for employers who make up pay differentials for employees whose military pay is lower than their civilian salary. Landrieu’s initiative would provide such employers tax credits equal to 50 percent of the salary differential payment. It also would provide tax credits to help compensate employers who have to hire temporary workers during periods when the permanent employee is mobilized.

House and Senate leaders now will have to negotiate these and other differences between their respective versions of the resolution in hopes of winning full congressional passage of a compromise resolution. At press time, they still had hopes of accomplishing that by the end of April.

The House also approved its version of the FY 2005 Emergency Supplemental Appropriations Act (H.R. 1268) before the Easter recess, including better benefits for families of people killed on active duty. The House bill would increase the military death gratuity to $100,000 and increase military life insurance coverage to $400,000. Currently those coverages are limited to $12,000 and $250,000, respectively.

The House plan would provide retroactive benefit increases to survivors of certain servicemembers killed on active duty since Oct. 7, 2001—the official start date of the war on terrorism. It would pay the extra $88,000 death gratuity when the death on active duty was a “direct result of an injury or illness ... incurred in Operation Enduring Freedom or Operation Iraqi Freedom, as determined under regulations prescribed by the secretary of defense.” The additional $150,000 insurance coverage (in the form of a special death gratuity) would be paid to families of servicemembers who died as a direct result of illness or injury incurred “in performance of military duty” as determined by the secretary of defense.

Military officials we’ve spoken to are concerned about the prospect of being forced to make hair-splitting decisions in defining what deaths meet the “performance of duty” criteria—such as how to determine whether a heart attack suffered in bed was a result of the stress of military duty. MOAA and uniformed services leaders had urged Congress to authorize the benefits for all servicemembers who died in the line of duty—the more traditional rules that assume active duty deaths are duty-related in the absence of misconduct or other disqualifying circumstances.

At press time, the Senate was expected to take up action on the supplemental appropriations measure in April, following the Easter recess.

SBP Needs Cosponsors

Contact your legislators to end inequities.

Push Your Legislators for SBP
We need a flood of constituent mail and phone calls to build support for SBP fixes. Use MOAA’s toll-free Capitol Hill hot line, (877) 762-8762, to ask your senators to cosponsor S. 185 and your representative to cosponsor both H.R. 808 and H.R. 968
On a continuing effort to win legislators’ support for much-needed fixes to the Survivor Benefit Plan (SBP), MOAA presented two special briefings to educate House and Senate staffers on SBP inequities that affect older retirees and survivors of active duty and retired servicemembers who die of service-connected causes.

Col. Lee Lange, USMC-Ret., deputy director of MOAA’s Government Relations Department, explained how survivors lose a dollar in SBP benefits for every dollar of Dependency and Indemnity Compensation (DIC) paid by the VA when the death is caused by military service. In many cases, these survivors are left with annuities of only $993 a month.

The briefings also highlighted how Congress penalized older retirees by delaying the effective date of 30-year, paid-up SBP coverage until 2008. Retirees who signed up for SBP in 1972 will end up paying six years longer and 34 percent more SBP premiums than a member of the same grade and years of service who retired in 1978.

Sens. Bill Nelson (D-Fla.) and Jon Corzine (D-N.J.) have joined to sponsor legislation (S. 185) that would fix both problems, effective Oct. 1, 2005. In the House, Rep. Henry Brown’s (R-S.C.) H.R. 808 would end the SBP-DIC offset. Rep. Jim Saxton’s (R-N.J.) H.R. 968 would move up the effective date of paid-up SBP. The latter two bills also would make the changes effective Oct. 1, 2005.

We need a flood of grassroots input to push legislators to cosponsor these bills. Visit MOAA’s Web site at http://capwiz.com/moaa/home and click on “Cosponsor SBP Fixes” to send your senators and representative an MOAA-suggested message.

Alternatively, call MOAA’s toll-free Capitol Hill hot line, (877) 762-8762, and ask your senators to cosponsor S. 185  and your representative to cosponsor both H.R. 808 and H.R. 968

Reserve Health Care Kick-Off

DoD announces April implementation.

DoD has issued new rules for TRICARE Reserve Select (TRS), its new health coverage plan for eligible members of the Selected Reserve (members of the National Guard or Reserve components who regularly train).

TRS health coverage is available to Guard and Reserve members mobilized since Sept. 11, 2001, and provides one year of premium-based coverage for each 90 days of qualifying active duty service. To be eligible for the TRS benefit, a member must:

  • have served 90 days or more of continuous active duty in a contingency operation;
  • agree to serve one year in the Selected Reserve for each 90 day period;
  • be qualified for continued service in the Selected Reserve; and
  • if released from active duty on or before April 26, 2005, sign a TRS agreement before Oct. 28, 2005.

Servicemembers still serving on active duty after the April 26 implementation date must sign a TRS agreement prior to release from active duty.

The TRS benefit structure is similar to the active duty TRICARE Standard health plan coverage, with the same deductibles ($150 single/$300 family), 20 percent copayment for inpatient and outpatient care, $3/$9 pharmacy copayments for generic/brand name drugs, and $1,000 out-of-pocket limit on deductibles and copayments.
 
One big difference from the active duty program is that drilling Guard and Reserve members would pay a premium for the coverage when they are not on active duty. By law, the premiums represent 28 percent of the government cost of the coverage.

For 2005, monthly premiums are: $75 ($900 annually) for self-only coverage and $233 ($2,796 annually) for self and family coverage.

Although this implementation is a major step forward, MOAA still is concerned that:

  • large numbers of Selected Reservists who need the coverage still are not eligible for it;
  • many who need it will be reluctant to cancel their permanent civilian coverage for temporary TRS coverage that might only last a few years; and
  • requiring members to make a TRS election before leaving active duty will encourage hasty decision making before members have a full opportunity to discuss this issue with family members most affected by the decision.

MOAA thinks Congress should expand TRS eligibility to cover all members of the Selected Reserve, and is hopeful this can be accomplished in upcoming consideration of this year’s Defense Authorization Bill.

See MOAA’s TRS fact sheet with questions and answers about this new program on MOAA’s Web Base at www.moaa.org/healthcare/trselect.asp.

Focus on “Chapter 61”

Bill seeks equity for combat-disabled early retirees.

Fighting for Fairness
MOAA is seeking full concurrent receipt for combat-disabled retirees forced to retire with less than 20 years of service and for those rated “unemployable” by the VA.
Concurrent receipt champion Rep. Mike Bilirakis (R-Fla.) has introduced a new initiative (H.R. 1366) to help address disabled servicemembers who were forced to retire before serving 20 years because of combat- or operations-related conditions. These servicemembers are called Chapter 61 retirees, after the chapter of the law that covers medical retirements.

Currently, only servicemembers who served long enough to retire independent of any disability are eligible for Combat-Related Special Compensation.

A servicemember with 20 years of service and a 10 percent combat-incurred disability has no retired pay offset for that disability. But a 100 percent combat-disabled servicemember forced to retire with 19 years and 11 months of service loses $1 of retired pay for each $1 received from the VA.

Bilirakis’ new bill would protect the share of retired pay such members earned by service. It would exempt from the VA offset an amount of retired pay equal to 2.5 percent of highest 3-year average basic pay times years of service. A servicemember who is disability-retired for combat wounds with 15 years of service would retain 37.5 percent of high-3 average basic pay from DoD in addition to his or her VA disability compensation.

In other concurrent receipt news, DoD still has not announced whether otherwise qualifying disabled retirees with “unemployable” ratings from the VA (and therefore paid at the 100 percent disabled rate) will be accorded immediate full concurrent receipt along with retirees specifically rated 100 percent disabled by the VA.

MOAA will report any decision when it is announced, and has asked Congress to act if DoD won’t do so.

Few Rxs Will Have $22 Copayment

Key panels consider initial formulary recommendations.

The TRICARE Uniform Formulary (UF) is coming this summer.

Under this new concept, selected drugs will be moved to “non-formulary” status, and beneficiaries will pay a $22 copayment for those drugs, versus the current $3 and $9 copayments for generic and brand-name drugs, respectively.

Designating the drugs is a multi-stage process. First, a Pharmacy and Therapeutics (P&T) Committee of medical professionals must review all drugs in a particular class. The P&T Committee can recommend moving one or more drugs in the class to non-formulary status if other drugs in the same class are just as effective and cost substantially less. Then a Beneficiary Advisory Panel (BAP) comments on the P&T Committee’s input and makes alternative recommendations, as necessary. The assistant secretary of defense, health affairs makes the final decision.

On March 23, at the DoD BAP’s first substantive meeting, the group agreed to the P&T Committee’s initial recommendation to make two drugs—Nexium and Teveten—non-formulary. Nexium is commonly prescribed for stomach problems and ulcers. Teveten is used to treat high-blood pressure.
All other drugs in these two categories will continue to be available for $3 (generic) and $9 (brand name) copayments. Drugs designated as non-formulary will have the following copayments:

  • TRICARE Retail Pharmacies: $22 for a 30-day supply.
  • TRICARE Mail-Order Pharmacy: $22 for a 90-day supply.
  • Non-network retail pharmacies: $22 or 20 percent of the cost, whichever is greater.
  • Non-formulary drugs will not be stocked in Military Treatment Facility pharmacies, but can be special-ordered in certain cases.

Patients can avoid incurring the higher copayments if their physician documents that there is a medical necessity for a particular patient to have the drug (e.g., because of adverse reactions to other drugs). In that case, the $9 copayment still will apply.

BAP members voted against the P&T Committee’s recommendation to implement the higher copayment within 30 days for Teveten and within 90 days for Nexium.

Sue Schwartz, deputy director of MOAA’s Government Relations Department and MOAA’s representative on the beneficiary panel, said that short schedule wouldn’t allow time to notify patients and their providers, let them consult on their options, and obtain approvals if a medical necessity is deemed appropriate. That’s especially true for Nexium because of the large number of beneficiaries with prescriptions for that drug.

MOAA and its partners at The Military Coalition also strongly opposed recommendations from two doctors on the BAP who proposed pushing many more drugs to non-formulary status to save DoD more money.

MOAA and other beneficiary representatives rejected this logic as overly restrictive, and DoD representatives agreed that their goal is to achieve cost savings with the least possible pain, and not to drastically curtail the TRICARE drug formulary.

Now, the panel recommendations will go to Dr. William Winkenwerder, assistant secretary of defense, health affairs, for a final decision. The timing of the change and rules for applying the new copayment structure will not be made public until Winkenwerder has signed the new rules, so the TRICARE pharmacy contractor (Express Scripts Inc.) can’t answer any questions about the program at this point.
After Winkenwerder acts, beneficiaries will be able to get more information about these issues from Express Scripts customer service by calling (866) 363-8779 or by going to www.tricare.osd.mil/pharmacy/trrx_contact.cfm.

Schwartz expressed concerns to the rest of the panel about the need to ensure the new three-tier formulary is fully explained to beneficiaries and their providers. “We have to educate beneficiaries and their providers about changes in the administration of their pharmacy benefit so they can make informed decisions and patients don’t get surprised with extra charges,” she said.

For more details on the uniform formulary visit: www.tricare.osd.mil/pharmacy/bap. For general information about the TRICARE pharmacy benefit visit: www.tricare.osd.mil/pharmacy.

New Age Issues

Saxton, Corzine reintroduce Reserve retirement bills.

Citizen Soldiers or Soldier Citizens?
The 55-year-old reserve retirement system assumed reservists would have full civilian careers and retirement benefits. Now, that system needs updating to recognize that vastly increased mobilization demands will crimp reservists’ retirement credits.
Rep. Jim Saxton (R-N.J.) and Sen. Jon Corzine (D-N.J.) have teamed up again to sponsor companion bills (H.R. 783 and S. 639, respectively) that would lower the reserve retirement age from 60 to 55. Lowering the reserve retirement age is one of MOAA’s key goals for the Guard and Reserve community.

In addition, Sen. Lindsey Graham (R-S.C.) has introduced his own “Guard and Reserve Readiness and Retention Act” (S. 337), which would reduce the reserve retirement age on a sliding scale. A reservist with 34 years of service could retire at 53; someone with 32 years of service at 54; and so on up to age 60 for those who have 20 qualifying years of service. Graham, a colonel in the Air Force Reserve, chairs the Senate Armed Services Subcommittee on Personnel, which should give the initiative more visibility than in the past.
 
When it was built in 1948, the reserve retirement age of 60 was picked to coincide with the federal civilian retirement age. Now, federal civilians can retire at age 55, depending on years of service.

Back then, its builders assumed reservists and guardmembers would have full-time civilian careers, with full civilian retirement coverage. But over the past 15 years, reserve call-ups have increased exponentially. Now Guard and Reserve members are told to expect an extended call-up (18 to 24 months) every six years. That can take 25 percent of their working lives.

Inevitably, this pace of activation will cut their civilian retirement coverage, 401(k) contributions, and promotion and career opportunities.

More than 430,000 Guard and Reserve members have been mobilized since Sept. 11, 2001. MOAA thinks the reserve retirement system must be updated to recognize the 21st century realities of Reserve service and sacrifice.

— Contributors are Col. Steve Strobridge, usaf-Ret., director; Col. Mike Jordan, USAF-Ret.; Col. Lee Lange, USMC-Ret.; Col. Bob Norton, USA-Ret.; Sue Schwartz, DBA, RN; Cmdr. René Campos, USN-Ret.; Cmdr. John Class, USN-Ret.; Cynthia Dougherty; and Maria Tutino, MOAA’s Government Relations Department.