Insurance negotiations at a standstill

by Sabrina Salas Matanane

Guam - GovGuam's health insurance contract negotiations remain at a standstill and it's not clear for how much longer either - but one thing is certain: the current health insurance contract for thousands of GovGuam employees and retirees expires in 40 days. 

"It's unfortunate and regretful that these actions need to be taken," said Frank Campillo, plan administrator for Calvo's Selectcare. Negotiations though already at a standstill as a result of a protest filed by Takecare Insurance earlier this month, went further south as Tokio Marine Pacific through its agent Calvo's Selectcare filed a protest Tuesday. "The system needs to be protected the procurement system needs to be protected the integrity of the system needs to be protected," he said.

According to Campillo it was actually through Takecare's filing of a protest and then posting it online that they learned the RFP process was allegedly compromised. "We were quite a bit surprised by the amount of information that was revealed in the protest by Takecare information that we didn't have knowledge of what had already occurred during this process," he said.

According to Campillo Takecare in their protest filings clearly were given an opportunity - along with another offeror - to change their proposal after the RFP was closed. "The basis of our protest is that after the government determined that two insurance providers including Takecare had submitted a non-responsive proposals to the RFP these two providers were allowed to unlawfully modify their proposals to attempt to make them compliant with the RFP requirements after the RFP submissions deadline had already past. this information was discussed publicly with Takecare in their protest documents were posted on their website we believe this is a blatant violation of Guam's procurement law and undermines the integrity of the procurement process and that's the reason why we decided to file this protest," he said.

Takecare which is already clouded with controversy over the Medical Loss Ratio issue for not paying rebates - but instead paying shareholders $15 million - claims the Department of Administration and the health insurance negotiating team failed to follow Guam procurement law and acted in such a way to discriminate against them, and although they are asking for all negotiations to cease until their protest is resolved Selectcare instead is asking that negotiations instead move forward with their company and the only other qualified offeror.

"The integrity of the procurement process suffers when the rules established to maintain fairness and equity are disregarded/ At this moment we would allow the administrative process to continue," he said.

But with the current health insurance contract to expire at in a little over one month, there's no telling when the matter will be resolved or whether GovGuam employees will be covered come October 1.