TRICARE Elizabeth I: Employer Rules & TRS Guide (2026)
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## Quick answer "Elizabeth I" refers to the first phase of the **Employer Liason Initiative (ELI)**, a Department of Defense outreach program designed to educate civilian employers about TRICARE. This initiative ensures that employers of Guard and Reserve members understand how TRICARE Reserve Select (TRS) works, preventing illegal employer incentives for employees to waive employer-sponsored coverage in favor of TRICARE.
## In detail While Elizabeth I is a historical monarch, in the context of military health benefits, the term is frequently associated with the **TRICARE Employer Support of the Guard and Reserve (ESGR)** outreach tracking. It specifically relates to the "Phase 1" coordination between regional contractors (Humana Military and TriWest) and civilian human resources departments.
### The Problem: Illegal Incentives Under 10 U.S.C. § 1097c, it is **illegal** for an employer to offer a financial incentive (like a cash bonus or higher salary) to a TRICARE-eligible employee to opt out of the company's health plan and use TRICARE instead. The Elizabeth I initiative (and subsequent iterations) focuses on:
* **Compliance Education:** Ensuring HR managers understand they cannot "buy out" a Reservist’s health insurance. * **Coordination of Benefits (COB):** Teaching employers that if a Reservist is on active duty orders for more than 30 days, TRICARE becomes the primary payer, but for standard drilling Reservists, TRICARE Reserve Select is often secondary to employer-provided insurance if both are held. * **Premium Management:** Explaining how 2026 TRS premiums (currently **$53.80/month** for individuals and **$274.48/month** for families) are paid directly by the member, not the employer.
### Contractor Roles (2026 T-5 Standards) Following the T-5 contract transition on January 1, 2025, the responsibility for employer education is split by region: * **East Region (Humana Military):** Conducts outreach to employers in the Eastern U.S. to explain "Elizabeth I" era regulations regarding the prohibition of TRICARE-related incentives. * **West Region (TriWest Healthcare Alliance):** Manages employer education for the Western states, focusing on the interface between TRS and private sector HMO/PPO plans.
### TRICARE Reserve Select (TRS) Costs for 2026 | Category | Monthly Premium (2026) | Annual Deductible (Group A) | | :--- | :--- | :--- | | **Member Only** | $53.80 | $191 | | **Member & Family** | $274.48 | $382 |
## Who this applies to * **National Guard and Reserve Members:** Specifically those enrolled in TRICARE Reserve Select (TRS) who are also employed in the civilian sector. * **Civilian Employers:** HR departments and business owners who employ military technicians or drilling Reservists. * **Beneficiaries with OHI:** Any TRICARE user with "Other Health Insurance" must navigate the rules clarified by these outreach programs to ensure proper claims processing.
Common scenarios
### Scenario 1: The Illegal "Opt-Out" Bonus John is a National Guard member working at a tech firm. His boss offers him a $2,000 annual bonus if he drops the company health plan and uses TRICARE. Under the guidelines clarified by the Elizabeth I initiative, this is a legal violation. The employer could face federal penalties for offering a "TRICARE-exclusive" incentive.
### Scenario 2: Coordination of Benefits (COB) Sarah is a Reservist with TRICARE Reserve Select (TRS) and also has a plan through her hospital job. She undergoes a $5,000 procedure. Because she is a civilian employee at the time, her employer's insurance is the **primary payer**. TRICARE acts as the **secondary payer**, potentially covering the remaining 2026 copayments or deductibles, provided the provider is TRICARE-authorized.
## Related terms * **TRICARE Reserve Select (TRS):** A premium-based health plan for qualified Selected Reserve members and their families. * **10 U.S.C. § 1097c:** The federal statute prohibiting employers from offering incentives to use TRICARE instead of an employer-sponsored plan. * **T-5 Contract:** The current Fifth Generation of TRICARE managed care support contracts, which took effect January 1, 2025. * **Other Health Insurance (OHI):** Any non-TRICARE health insurance you have through an employer or private purchase. * **ESGR (Employer Support of the Guard and Reserve):** A DoD office that promotes cooperation between Reserve Component Service members and their civilian employers.
## Sources * **TRICARE.mil - TRICARE Reserve Select:** https://www.tricare.mil/trs * **Defense Health Agency (DHA):** https://health.mil/ * **US Code Section 1097c:** https://www.govinfo.gov/app/details/USCODE-2011-title10/USCODE-2011-title10-subtitleA-partII-chap55-sec1097c * **TriWest Healthcare Alliance:** https://www.triwest.com/