PILOT PROGRAM TO ASSIST CERTAIN MEMBERS OF THE ARMED FORCES AND DEPENDENTS WITH ADDITIONAL SUPPLEMENTAL COVERAGE RELATING TO CANCER HT9402-26-RFI-0255

The Defense Health Agency (DHA) is currently in the planning phase for partnering with carriers of supplemental insurance focused on cancer coverage. This Request for Information (RFI) is intended to initiate market research efforts as the Government considers structuring processes to meet Congress intent. Section 734 of the National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2026 (Enclosure 1) requires DHA to establish a pilot program not later than September 30, 2027, under which members of the regular component of the Army, Navy, Marine Corps, Air Force, or Space Force and their dependents enrolled in TRICARE may obtain supplemental cancer insurance for noncovered expenses under a fixed indemnity supplemental benefit. The supplemental coverage is intended to provide financial assistance for noncovered expenses related to cancer screening, diagnosis and treatment that are not otherwise covered by the health care benefits the individuals receive under chapter 55 of title 10, United States Code, or any other benefit provided by the Secretary of Defense. https://www.congress.gov/119/plaws/publ60/PLAW-119publ60.pdf RFI Instructions: Prepare and submit a written response addressing each of the questions below. This response shall not exceed 20 pages in length and should not be solely your company s general capability statement but instead specifically address the Government s topics listed in this RFI. Please send your responses to the Defense Health Agency, Managed Care Contracting Division [email protected] by Close of Business 18 September 2026. RFI Questions: Plan Types and Coverage Scope Describe how a TRICARE specific plan would differ from current commercially available plans. What non-covered services under TRICARE would be covered? Would there be portability options if a beneficiary is no longer eligible for TRICARE? How could your company intend to add value to TRICARE beneficiaries? Describe an applicable case scenario. Coverage Details and Exclusions Detail general coverages provided in similar plans. Would there be any key coverage exclusions and limitations, including but not limited to: Acts of War, specific cancer types, pregnancy, and state-based restrictions? What annual or lifetime maximums on benefits would apply, and what conditions or treatments would be subject to caps or exceptions? What coverage would be provided for non-FDA approved drugs, participation in clinical trials, or other emerging and unproven treatments? Would pre-existing conditions be covered? If yes, what conditions would be included? Would there be any coverage limitations for a recurring diagnosis (remission or new)? In which states does your company offer coverage, and are there any state specific exceptions or restrictions that would apply to a TRICARE specific plan? How would this impact our mobile beneficiary population? Do your company s plans provide coverage for beneficiaries residing or receiving care overseas? Eligibility and Enrollment Per the NDAA, the Government will not be subsidizing this pilot. To be financially viable, is there a minimum required enrollment threshold for such an unsubsidized, no cost, 100% beneficiary paid, group plan to be offered by your company? Is there a preferred eligibility verification process? What would prevent a member from being eligible? Describe the enrollment process and the expected burden on the beneficiary. When would coverage be effective? Any limitations? How would beneficiaries make premium payments? How are premiums structured today (in similar policies)? How would your company structure TRICARE premiums based on pilot requirements? Would premium rates be locked in for the duration of the pilot? Describe the termination of coverage process and the expected burden on the beneficiary. Claims and Payments How are claim payments determined and processed, including if lump sum payments are one-time or recurring, and any applicable limitations? Would payments be tax…