by Mindy Aguon
Guam - Calvo's SelectCare doesn't intend to disclose information requested by Acting Governor Mike Cruz, saying the company already provided extensive and detailed information to justify the required rate increases for Government of Guam workers and retirees. In a response to the acting governor, plan administrator Frank Campillo stressed that utilization and claims data for various years were provided to the negotiating team and the actuary from Aon Consulting Services.
"The data reflected the impact this year of changing the applicability of the deductibles to exempt drugs and physician services and the resulting high claim utilization during the Fiscal Year 2010 plan year. Your office publicly embraced the changes in benefits and praised the negotiating team for the work done during the negotiations of the FY2010 benefit year. These were the same group of individuals who negotiated benefits and rates for FY2011," Campillo wrote.
SelectCare is the only local insurance provider that bid on the health insurance plan for the coming year. The plan administrator reminded Cruz that when Guardian Life withdrew coverage last year, SelectCare allowed a special open enrollment and accommodated the employees and retirees who would have had no dental coverage.
Campillo asked the acting governor to meet with the negotiation team to review the data to satisfy his concerns regarding fairness reminding him that SelectCare complied with the requirements of the request for proposal, provided the necessary claims data to evaluate the utilization rates to the team and the actuary and followed the rules of the open bidding process.
He asked the acting governor to sign the contract to avoid interruption of medical services reminding him that compliance with new federal mandates must be completed by October 1 and there will be repercussions if the government plan is non-compliant. Cruz told KUAM News on Tuesday that he wants the team to go back and renegotiate lower rates.