TRICARE Dental Program 7/Third Party Administrator Industry Forum

The Defense Health Agency (DHA) is developing the 7th generation of the TRICARE Dental Program (TDP) contracts, as well as a Third-Party Administrator (TPA) contract to provide services to the TDP-7 contract. The DHA desires to identify commercial best practices in delivering the TRICARE dental benefit and TPA services. The TPA contractor will manage the administrative features of the premium sharing plans in TDP-7, including eligibility, enrollment, plan changes, premium payment processes, reconciliation, submission of qualifying life events, and address changes for eligible TRICARE beneficiaries. • The TDP-7 contract will remove several responsibilities performed under the TDP-6 contract and transfer them to the TPA contract. • The DHA expects to contract with two to four dental insurance carriers to deliver the TDP-7 requirements. • The TPA contractor will provide customer service support for TDP, including plan changes, submission of qualifying life events, and address changes. • The TPA contractor will provide related premium/allotment administration services. • The TPA contractor will provide a mechanism to reconcile enrollments, premiums, and allotments completely and accurately at the individual enrollee level with each TDP carrier.