PM 23-08-04-a: What to Report as TPL

WAG 23-08-04-a

Federal regulations require the TPL Section to enter health insurance information into MMIS within 60 days of the later of the approval or discovery date.

Report any of the following TPL sources to the TPL Section:

  • Group health insurance - This can be through an employer, union, or other group.
  • Individual health insurance - This is when an individual purchases health insurance directly from an insurance company.
  • Health insurance or other medical support ordered as part of child support.
  • Prepaid health plans - The most common type is a Health Maintenance Organization (HMO).

    NOTE: Do not report HMOs that HFS pays for.

  • CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) - Covers off-base medical services for dependents of active or retired uniformed service personnel. This includes dependents of personnel who died after retirement.

    NOTE: Dependents of reserve personnel are not covered by CHAMPUS. 

  • CHAMPVA (Civilian Health and Medical Program Veterans Administration) - Covers medical services for dependents of living and deceased disabled veterans.
  • Indemnity or income protection plans. These plans pay a certain amount for each day the insured person is disabled or confined.
  • Limited policies, such as cancer or surgical only policies.
  • School insurance for college students.
  • Prescription drug policies.