Health Insurance negotiations for gov't of Guam Group completed


Health Insurance negotiations for gov't of Guam Group completed

by: . | .
Office of Senator Rodriguez | .
published: September 12, 2014

(Tamuning, Guam) Health Committee Chairman Senator Dennis G. Rodriguez, Jr. says the FY-2015 Government of Guam Group Health Insurance plan finalized and announced today is a major step forward on coverage for government workers and retirees, while at the same time saving taxpayers more than a $1 million over the current contract.

Rodriguez notes the new government health insurance contract features more choices at lower cost premiums, does a much better job of defining benefits so they are easier to understand, increases access to world class care, provides more treatment options, and elevates health & wellness coverage to scheduled benefit status.

Senator Rodriguez, who serves as a member of the insurance contract negotiating team, sought full inclusion under the plan for retirees with Medicare coverage who seek treatment in the Philippines.

“Starting October 1, this policy will provide coverage in the Philippines when Medicare is denied. Retirees who go to the Philippines for care at facilities including St. Luke’s and Medical City will receive the same schedule of benefits, ending the requirement they go through more expensive travel costs and delay in care to treatment centers in Hawaii and California,” says Rodriguez.

The Health Committee Chairman says he is especially pleased with what the FY 2015 health contract does for retirees and thanks fellow negotiating committee members for holding insurers competing for the lucrative Government of Guam contract accountable to the needs of retirees.

“This new contract is more inclusive, more just, and more favorable to our retirees,” Rodriguez says.  “It does a much better job of addressing their needs.”

The Health Committee Chairman says the logical next step is to extend this same level of coverage to commercial and federal plans and committed to work with insurers to make this a reality.

Another significant improvement is that language was added which placed your care more fully in the hands of your physician.  Old language too often required that treatment prescribed by your doctor meet the approval of the company, which often made the process all but impossible.

Says Rodriguez, “Your care should be determined by your physician, not an accountant desiring to lower costs.  Now if your doctor asserts that the treatment is medically necessary, then you get it, just so long as it is in the scope of benefits which have been significantly improved.”

The provision of Health and Wellness programs, to include gym membership and other wellness initiatives, are all directly included in the schedule of benefits.

“These are benefits I have always believed are crucial to preventative healthcare.  We spend millions annually on sick-care, as compared to the very little we spend on keeping our community healthy.  The FY-2015 plan ensures that employees, retirees and dependents can conveniently take advantage of this opportunity to engage in healthy lifestyles,” states Rodriguez.

Senator Rodriguez gratefully acknowledges and commends the efforts of the negotiating team, which consists of representatives from various government of Guam agencies, to include retirees.  Rodriguez’s membership on the negotiating Team as the Legislative Chairperson of the Committee on Health & Human Services and Health Insurance Reform was made possible by Public Law 31-24 that he authored.

“The Health and Health Insurance Reform Chair serves as an advocate for the government of Guam employees, dependants, retirees and all the people of Guam in the provision of healthcare insurance coverage. I encourage our employees, dependents, and retirees to actively participate in the open enrollment process to better understand the choices available to them so they may select the best plan for their coverage,” Rodriguez concluded.

For more information, contact the Office of Senator Dennis G. Rodriguez, Jr. at 649-8638.

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