Guam -Vice Speaker B.J. Cruz believes that the Government of Guam and individual GovGuam employees are entitled to an $8.7 million dollar rebate from Calvo’s SelectCare Insurance because a federal law requires insurers to provide rebates, if the amount spent on medical services does not meet a minimum standard of value based on the premium dollars paid into the health insurance plan.
The Federal law, is the Patient Protection and Addordability Care Act, which, Senator Cruz argues, requires a rebate be paid if the insurance companies medical loss ratio is less than 85%.
The Vice Speaker has sent a letter to Appropriations Committee Chair Senator Ben Pangelinan citing the federal law and he includes calculations which he says show that this year’s SelectCare Health Insurance plan is tracking a medical loss ratio of below 60% for the first three quarters.
As a result, the Vice Speaker believes that GovGuam is entitled to a $6.5 million dollar rebate from SelectCare and individual GovGuam employees are entitled to split $1.9 million dollars in rebates.
The Vice Speaker is so sure of his analysis that he has sent Senator Pangelinan an amendment to the budget bill which includes an additional $6.5 million dollars in revenue he believes that SelecCare owes as a rebate to GovGuam.