Executive Summary: The Veteran at a Small Employer: TRICARE Coordination Nobody Manages

ADJ.05 — Adjacent

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Approximately 1.9 million veterans are employed by small businesses, per SBA Office of Advocacy data. When a veteran employed at a small employer is offered group health coverage, they face a TRICARE coordination decision their employer’s broker cannot competently advise on. TRICARE Reserve Select carries monthly premiums of approximately $52 for individual and $263 for family coverage in 2026. Most employer-sponsored plans at small employers cost the employee $150 to $400 per month in premium contributions for family coverage. The veteran who can keep TRICARE has better coverage at lower cost than what the employer offers. The decision depends on the veteran’s specific TRICARE eligibility category, the employer’s plan design, and coordination-of-benefits rules that neither the broker nor the HR contact has been trained to apply.

The structural explanation is that TRICARE and the commercial group insurance market were designed by different agencies for different purposes and have never been integrated into a coherent decision framework for the veteran at a small employer. The Defense Health Agency publishes TRICARE plan descriptions for individual beneficiary navigation, not employer benefit decision-making. When coordination fails, the veteran absorbs out-of-pocket costs that the secondary payer should have covered. Three veterans in a 15-person firm who decline coverage in favor of TRICARE can push group participation below the carrier’s or stop-loss underwriter’s minimum threshold.

The broker or TPA that develops genuine TRICARE coordination expertise, advises employers on participation rate implications of veteran waivers, trains the HR contact on coordination-of-benefits documentation, and helps veterans make the enrollment decision accurately creates a differentiator in employer segments with high veteran concentration: defense contracting supply chains, law enforcement, healthcare systems with military-adjacent hiring, and skilled trades near military installations. The cost of developing this expertise is low; TRICARE plan structures and coordination rules are published. The value is high: the employer who gets TRICARE coordination right retains veterans who would otherwise leave for a larger employer with a benefits team that understands their situation.