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Defense Health Agency

"On October 1, 2013, the Department of Defense established the Defense Health Agency (DHA) to manage the activities of the Military Health System. These activities include those previously managed by TRICARE Management Activity (TMA), which was disestablished on the same date. During the next several months, all TMA websites will change to reflect the new DHA. We appreciate your patience during this transition."

Personnel Security Branch

SYSTEM/NETWORK ACCESS FORMS

Non-Disclosure Agreement Template

Contractor Non-Disclosure Agreement template must be printed on the contract company’s letterhead and signed by all personnel working on TRICARE contracts. A copy of the form should be retained by the company in the contractor’s personnel file.

Common Access Card (CAC)

New employees hired by a contractor may be granted interim ADP/IT II access to obtain a CAC by TMA PSB when the FBI fingerprint check and the advance NAC are favorable, and the required investigation has been scheduled by OPM. The contractor company FSO will be notified by TMA PSB when the contractor is approved for interim ADP/IT II access. The FSO must then submit a TMA OA Form 33 “Request for TMA Contractor DoD Common Access Card” to the TMA CVS & Common Access Card Branch (CVS/CACB).

Defense Enrollment Eligibility Reporting System (DEERS)

ALL contractor personnel accessing the DEERS Database or the Business to Business (B2B) Gateway must have, as a minimum, an ADP/IT-II Trustworthiness Determination.

Before an individual can have access to a TMA/MHS System housed on a DISA information system, the individual must have the most current version of the DD 2875, System Authorization Access Request (SAAR).Contracting companies that require access to a DISA system through the B2B gateway must complete and submit this form to TMA PSB.

The process of obtaining authorized access to a DISA information system is that the individual must have the following:

  • A favorable FBI fingerprint check and a scheduled government investigation for their ADP position designation.
  • Verification of the need-to-know from the owner of the data.
  • The appropriate IT level designation/security clearance, if applicable, Information Awareness (IA) training.

You may also obtain the DD Form 2875 on the DISA website: http://www.disa.mil/

Instructions for completing the DD Form 2875:

Type of Request will be filled out by the individual who will be accessing the DISA System, the System Name and Location will be filled in by the Company or Program Office.

Part 1
Blocks 1-12, and block 26 will be completed and signed by the individual requesting access to the DISA system.

Part II
Blocks 13-20b will be completed by the Supervisor or the Government Sponsor of the individual requesting access to the system.

Part III
Blocks 28-32 will be completed by the Contractor Security Manager validating the background investigation or clearance information.

Blocks 21a-21c will be completed by the Information Owner (functional appointee responsible for approving access to the system being requested).

Blocks 22-25 will be completed by the Information Assurance Officer (IAO)

Part IV
Completed by the DISA representative at the site where this information is housed.

The Facility Security Officer must notify TMA PSB and CVS/CACB immediately upon termination of the contractor employee.