I Mina'Trentai Kuåttro Na Liheslaturan BILL STATUS

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1 34th GL CLERKS OFFICE Bill HISTORY 4/20/2018 1:18 PM I Mina'Trentai Kuåttro Na Liheslaturan BILL STATUS BILL NO (COR) SPONSOR James V. Espaldon B. J.F. Cruz TITLE AN ACT TO AMEND ITEMS (a) AND (b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. DATE INTRODUCED 2/14/18 11:49 a.m. DATE REFERRED CMTE REFERRED 2/21/18 Committee on Appropriations and Adjudication 2/26/18 Re referred : Committee on Health, Tourism, Military Affairs and Senior Citizens PUBLIC HEARING DATE 4/12/18 8:30 a.m. DATE COMMITTEE REPORT FILED 4/20/18 10:48 a.m. FISCAL NOTES Fiscal Note Request 2/22/18 Fiscal Note 3/6/18 NOTES Page 1

2 SENATOR DENNIS G. RODRIGUEZ, JR. April 18, 2018 Honorable Benjamin J.F. Cruz Speaker I Mina'Trentai Kuattro Na Liheslaturan Guahan 163 Chalan Santo Papa Hagatfia, Guam 9691 O VIA: The Honorable Regine Biscoe Lee '@ Chairperson, Committee on Rules RE: Committee Report- Bill No (COR) A ' Dear Speaker Cruz: Transmitted herewith, for your consideration, is the Committee Report on Bill No (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF 4301OF4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. As introduced, was publicly heard on April 12, ::::::.. ::3: 9... c::: 1 Committee votes are as follows: --. TO PASS NOTTO PASS - ABSTAIN {R_ - TO REPORT OUT ONLY TO PLACE IN INACTIVE FILE Senseramente, tj.v Senator Dennis G. Rodriguez, Jr. Chairman Attachments 1 RECEIVED APR c$1je~~les Chairman, Committee on H ealth, Tourism, Militaiy Affairs and Senior Citizens Ujisi11a11 Todtt Gt1atll I Mina' T rwtai Kutittro Na Liheslatt1ra11 G11tiha11 34th G11am Legislature Ran Care Bldg., Suite Bl, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (8638) /Facsimile: / E -mail: senatordrodriguez@gmail.com /

3 SENATOR DENNIS G. RODRIGUEZ, JR. COMMITTEE REPORT ON Bill No (COR) - Sponsored by: James V. Espaldon I B. J. F. Cruz Bill No (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. Chairman, Committee on Health, Tourism, Military Affairs and Senior Citizens Ujisi11a11 Tod11 Guam I Mi11a' T rwtai K11attro Na Uheslat11rat1 G11aha11 34th Guam Legislature Ran Care Bldg., Suite B1, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (8638) /Facsimile: / senatordrodriguez@gmail.com /

4 SENATOR DENNIS G. RODRIGUEZ, JR. April 18, 2018 MEMORANDUM To: From: Subject: ALL MEMBERS Committee on Health, Tourism, Military Affairs and Senior Citizens Senator Dennis G. Rodriguez, Jr. {)-v Committee Chairperson Committee Report on Bill No (COR) Transmitted herewith, for your consideration, is the Committee Report Bill No (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF ~ 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. This report includes the following: Committee Voting Sheet Committee Report Narrative/Digest Copy of Bill No (COR) Public Hearing Sign-in Sheet Copies of Submitted Testimony and Supporting Documents Copy of COR Referral of Bill No (COR), As introduced Copy of COR Fiscal Note Request/Fiscal Note Notices of Public Hearing (1 st and 2nd) Copy of the Public Hearing Agenda Related News Articles (Public hearing publication of public notice) Please take the appropriate action on the attached voting sheet. Your attention to this matter is greatly appreciated. Should you have any questions or concerns, please do not hesitate to contact me. Si Yu 'os Ma 'ase'! Attachments Chairman, Committee on Health, Tourism, Military.Affairs and Senior Citizens Ufisi11a11 To d11 G11all! I Mina' T re11tai K11Jttro Na Liheslat11ra11 G11Jha11 34th G11all! Legislat11re Ran Care Bldg., Suite Bl, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (8638) /Facsimile: / senatordrodriguez@gmail.com /

5 Senator Thomas C. Ada. Vice Chairperson Speaker Benjamin J.F. Cruz. Vice Speaker Therese M. Terloje. Senator Fronk B. Aguon. Jr.. Senator Teleno c. Nelson, MEMO 8.. ' - COMMITTEE, ON RULES SENATOR REGINE BISCOE LEE. CHAIR SIKRITARIAN LIHESLATURAN GUAHAN I MINA'TRENTAI KUATTRO NA LIHESLATURAN GUAHAN LEGISLATIVE SECRETARY 34TH GUAM LEGISLATURE. February Senator Dennis G. Rodriguez. Jr.. Senator Joe s. San Agustin, Senator Michael F.Q. San Nicolas. Senator James V. Espaldon. Senator Mary Camacho Torres, To: Rennae Meno Clerk of the Legislature Attorney Julian Aguon Legislative Legal ~ounsel From: Re: Sti!nator Regine Biscoe Lee Chairperson, Committee on Rules Referral of Bill No (COR) Buenos yon Hafa adai. As per my authority as Chairperson of the Committee on Rules and subject to 6.01 (d) (1). Rule VI of our Standing Rules (see B(3) of the pre-referral checklist), I am forwarding the referral of Biii No (COR). Please ensure that the subject bill is referred, in my name, to Speaker Benjamin J.F. Cruz, Chairperson of the Committee on Appropriations and Adjudication. I also request that the same be forwarded to the prime sponsor of the subject bill. After committee review, the subject bill may be further referred by the Committee on Appropriations to the Principal Committee of subject matter jurisdiction, pursuant to 6.01 (d)(l ), Rule VI of our Standing Rules. If the Committee on Appropriations determines that a subsequent referral is in order, the Committee on Rules respectfully advises that the subject bhi be referred to Senator Dennis G. Rodriguez. Jr., Chairperson of the Committee on Health, Tourism, Mlitary Affairs and Senior Citizens. Attached, please see the COR pre-referral checklist for your information, which shall be attached as a committee report item to the bill. If you have any questions or concerns, please feel tree to contact Jean Cordero, Committee Director at Thank you for your attention to this important matter... ~ ---~--- GUAM CONGRESS BUILDING 163 CHALAN SANTO PAPA HAGAT~A. GUAM Telephone: (671) address: corguamleglslaturc@gmail.com

6 /16/2018 Gmail - FIRST NOTICE OF PUBLIC HEARING on Thursday, April 12, 2018 M Gmail Maria Loraine Umbrero <mumbrero.senatordrodriguez@gmail.com> FIRST NOTICE OF PUBLIC HEARING on Thursday, April 12, message Joe Mesngon <joe@toduguam.com> To: phnotice <phnotice@guamlegislature.org> Fri, Mar 30, 2018 at 9:55 AM March 29, 2018 MEMORANDUM To: From: All Senators, Stakeholders & Media Sen. Dennis G. Rodriguez, Jr. Subject: FIRST NOTICE of PUBLIC HEARING on April 12, 2018 Hafa Adai! The Committee on Health, Tourism, Military Affairs and Senior Citizens will conduct a Public Hearing on Thursday, April 12, 2018, at 8:30am in the Guam Congress Building Public Hearing Room in Hagatna. The Committee will accept oral and written testimony on the following: Bill No (COR) - James V. Espaldon I B. J.F. Cruz AN ACT TO AMEND ITEMS (a) AND (b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. Bill No (COR) - Louise B. Muna I Telena C. Nelson I Therese M. Terlaje I Mary Camacho Torres I Regine Biscoe Lee AN ACT TO ADD A NEW TO ARTICLE 10, CHAPTER 18, TITLE 22, GUAM CODE ANNOTATED AND TO REPEAL SUBSECTION (e) OF 4301, ARTICLE 3, CHAPTER 4, TITLE 4, GUAM CODE ANNOTATED RELATIVE TO BREAST CANCER SCREENING COVERAGE IN HEALTH INSURANCE/BENEFIT PLANS SOLD ON GUAM AND BY MEDICAID AND THE MEDICALLY INDIGENT PROGRAM (MIP). Written testimony may be addressed to Sen. Dennis G. Rodriguez, Jr., Chairman and sent via to senatordrodriguez@gmail.com or hand delivered to his office at 761 S. Marine Corps Drive Suite B1 Tamuning, Guam or the Guam Congress Building Mailroom at 163 Chalan Santo Papa Hagatna, Guam Individuals who may require special accommodations are asked to contact the office of Sen. Rodriguez at /0511 no later than 48 hours prior to the scheduled hearing. For more information, please call our office. Si Yu'os Ma'ase'! Joseph A. Q. Mesngon Deputy Chief of Staff Office of Senator Dennis G. Rodriguez, Jr. Committee on Legislative Operations, Health, Tourism, Military Affairs and Senior Citizens I Mina' Trentai Kuattro N a Liheslaturan G11ahan 34th Guam Legislature 761 S. Marine Corps Drive Suite 81

7 ./16/2018 Tamuning, Guam Tel: /0511 Fax: Gmail - FIRST NOTICE OF PUBLIC HEARING on Thursday, April 12, 2018

8 1/16/2018 Gmail - SECOND NOTICE OF PUBLIC HEARING on Thursday, April 12, 2018 M Gmail Maria Loraine Umbrero <mumbrero.senatordrodriguez@gmail.com> SECOND NOTICE OF PUBLIC HEARING on Thursday, April 12, message Joe Mesngon <joe@toduguam.com> To: phnotice <phnotice@guamlegislature.org> Thu, Apr 5, 2018 at 11 :16 AM April 5, 2018 MEMORANDUM To: From: All Senators, Stakeholders & Media Sen. Dennis G. Rodriguez, Jr. Subject: SECOND NOTICE of PUBLIC HEARING on April 12, 2018 Hafa Adai! The Committee on Health, Tourism, Military Affairs and Senior Citizens will conduct a Public Hearing on Thursday, April 12, 2018, at 8:30am in the Guam Congress Building Public Hearing Room in Hagatna. The Committee will accept oral and written testimony on the following: Bill No (COR) - James V. Espaldon I B. J.F. Cruz AN ACT TO AMEND ITEMS (a) AND (b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. Bill No (COR) - Louise B. Muna I Telena C. Nelson I Therese M. Terlaje I Mary Camacho Torres I Regine Biscoe Lee AN ACT TO ADD A NEW TO ARTICLE 10, CHAPTER 18, TITLE 22, GUAM CODE ANNOTATED AND TO REPEAL SUBSECTION (e) OF 4301, ARTICLE 3, CHAPTER 4, TITLE 4, GUAM CODE ANNOTATED RELATIVE TO BREAST CANCER SCREENING COVERAGE IN HEALTH INSURANCE/BENEFIT PLANS SOLD ON GUAM AND BY MEDICAID AND THE MEDICALLY INDIGENT PROGRAM (MIP). Written testimony may be addressed to Sen. Dennis G. Rodriguez, Jr., Chairman and sent via to senatordrodriguez@gmail.com or hand delivered to his office at 761 S. Marine Corps Drive Suite B1 Tamuning, Guam or the Guam Congress Building Mailroom at 163 Chalan Santo Papa Hagatna, Guam Individuals who may require special accommodations are asked to contact the office of Sen. Rodriguez at /0511 no later than 48 hours prior to the scheduled hearing. For more information, please call our office. Si Yu'os Ma'ase'! Joseph A. Q. Mesngon Deputy Chief of Staff Office of Senator Dennis G. Rodriguez, Jr. Committee on Legislative Operations, Health, Tourism, Military Affairs and Senior Citizens I Mina' Trentai Kuattro Na Uheslat11ran G11ahan 34th Guam Legislature 761 S. Marine Corps Drive Suite 81

9 f/16/2018 Tamuning, Guam Tel: /0511 Fax: Gmail - SECOND NOTICE OF PUBLIC HEARING on Thursday, April 12, 201 8

10 SENATOR DENNIS G. RODRIGUEZ, JR. I Mina' TrentaiKuattronaLiheslaturanGuahan Chainnan, Committee on Health, Towism, Military Affairs & Senior Citizens PUBLIC HEARING AGENDA Thursday, April 12, 2018 at 8:30AM Public Hearing Room, I Liheslatura I. Call to order II. Items for public consideration: BILL NO (COR) - AN ACT TO AMEND ITEMS (A) AND (B) OF ~ 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. BILL NO (COR) - AN ACT TO ADD A NEW TO ARTICLE 10, CHAPTER 18, TITLE 22, GUAM CODE ANNOTATED AND TO REPEAL SUBSECTION (E) OF 4301, ARTICLE 3, CHAPTER 4, TITLE 4, GUAM CODE ANNOTATED RELATIVE TO BREAST CANCER SCREENING COVERAGE IN HEALTH INSURANCE/BENEFIT PLANS SOLD ON GUAM AND BY MEDICAID AND THE MEDICALLY INDIGENT PROGRAM (MIP). III. Adjournment Thank you for your participation in today's hearing. Ufi sinantodu Guam 761 S. Marine Corps Drive, Suite Bl, Tamuning, Guam I Telephone: TODU (8638) I Facsimile: F-mail ~P.nMorclroori P"J 1 ezlal l!lll a i1.com I com

11 S EN AT 0 R D EN NI S G. R 0 D RIG U E Z, Jr., Chairman COMMITTEE ON HEALTH, TOURISM, MILITARY AFFAIRS & SENIOR CITIZENS Mina 'trentai Kuatro Na Liheslaturan Guahan 34rdGuam Legislature PUBLIC HEARING Thursday, April 12, :30 AM Guam Congress Building Public Hearing Room UllNo (COR)-AN ACT TO AMEND ITEMS (a) AND (b) OF 4301OF4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP EALTHINSURANCEPROGRAM. PRINT NAME SIGN AGENCY or,/oral '1WRITTEN '1NO '11N,; CONTACT ADDRESS ORGANIZATION INITIALS TESTIMONY TESTIMONY TESTIMONY FAVOR OPPOSE NUMBERS ~rt\ ~ ~ ) ~\Jv[ s introduced by: James V. Espaldon I B. J.F. Cruz age \ of_\

12 SENATOR DENNIS G. RODRIGUEZ, JR. COMMITTEE VOTING SHEET Bill No (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF~ 4301OF4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. DENNIS G. RODRIGUEZ, Jr. Chairman JOE S. SAN AGUSTIN Vice Chairman FERNANDO B. ESTEVES Vice Chairman on Health SIGNATURE TO PASS NOT TO PASS ABSTAIN REPORT OUT ONLY PLACE IN INACTIVE FILE BENJAMIN J.F. CRUZ THERESE M. TERLAJE FRANK B. AGUON, JR. THOMAS A. MORRISON WILLIAM M. CASTRO LOUISE BORJA MUNA Chairman, Committee on Health, Tourism, Military Affairs and Senior Citizens Ufisi11a11 T od11 G11am I Mi11a' T rwtai K11attro Na Llheslat11ra11 G11aha11 34th G11a111 Legislat11re Ran Care Bldg., Suite Bl, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (863 8) /Facsimile: / E -mail: senatordrodriguez@gmail.com /

13 SENATOR DENNIS G. RODRIGUEZ, JR. COMMITTEE REPORT DIGEST Bill No (COR) OVERVIEW: The Committee on Health, Tourism, Military Affairs and Senior Citizens conducted a Public Hearing on April 12, The hearing convened at 08:30am in I Liheslatura' s Public Hearing Room. Among the items on the agenda was the consideration of Bill No (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. I. Public Notice Requirements Notices were disseminated via hand-delivery/fax and/or to all senators and all main media broadcasting outlets on March 29, 2018, and April 5, Senators Present Senator Dennis G. Rodriguez, Jr. Senator James Espaldon Senator Therese Terlaje Senator Regine Biscoe Lee Chairman II. SUMMARY OF TESTIMONY & DISCUSSION Hearing for Bill (COR)- Thursday, April 12, 2018 Public Hearing for Bill No on April 10th, 2018 Senator Rodriguez: I'd like to recognize Senator James Espaldon. Senator Espaldon: Thank you, Mr. Chairman. Morning everybody. Mr. Chairman, Bill mandates certain changes to the Government of Guam group health insurance program that would streamline the process and result in lower costs to the Govermnent of Guam without compromising the quality of Government of Guam Health Insurance. Currently, the legislative and judicial branches of government may choose to enter into separate health insurance contracts for the employees or choose to remain with the executive branch health insurance contract if the legislative and judicial board March 1st. The government of Guam health insurance proposal is developed between mid-february and mid-april mandating that all entities under the executive department remain as part of the group health insurance and establishing the March 1st deadline for participation by the legislative and judicial branches locks in perspective enrollees for better rate development by the responding health insurance companies. This bill also requires that all Govermnent of Guam retirees and survivors enrolled in Medicare Parts A and B and who select Class 1 or Class 2 be enrolled in the retiree supplemental plan otherwise known as the RSP. At present all participation in the RSP is on a voluntary basis but the Government of Guam health insurance negotiating team has Chairman, Committee on Health, Tourism, Military Affairs and Senior Citizens Ufisi11a11 Todu Guam I Mi11a' T m1tai KuJttro Na Lihes!at11ra11 G11Jha11 34th G11am Legislature Ran Care Bldg., Suite Bl, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (8638) /Facsimile: / senatordrod.riguez@gmail.com /

14 SENATOR DENNIS G. RODRIGUEZ, JR. been advised by its legal counsel that the statute must be changed to mandate required enrollment in the RSP. Many retirees and their survivors enroll in the PPO 1500 and become overly oversubscribed at great expense to the government. By mandating enrollment in the RSP, the government's contribution for Class 1 and Class 2 where we will be reduced on average by $255 dollars and 14 cents per day period or $6123 and 36 cents annually and $518 per pay period or $12,452 annually per subscriber respectively. As of January 2018, 399 retirees and survivors are enrolled in the PPO 1500 class. If all these subscribers are migrated to the RSP, the potential savings to the government would be $2,443,220 for Class 1 and $903,625 for Class 2 or basically for a grand total of savings of $3,418,846 annually to the government. Benefit coverage will not be impacted as the RSP mirrors and even exceeds what Medicare offers as benefits. Additionally, the RSP offers treatment in the Philippines and other countries where Guam health insurance companies have provider agreements. RSP subscribers are all also able to opt for dental coverage which are the same rates as all other subscribers. Finally, Bill No. 243 also mandates that the Government of Guam contribution for retired employees and survivors shall not exceed three times the lowest premium for a single active employee. This bill also mandates the current level of government contribution be maintained. Health insurance is one area where we can streamline things and realize some savings for the Government of Guam. We must look at all of the saving options for revenue enhancing measures in the days ahead. This bill in essence will help save the government approximately 3.4 million dollars at minimum. Thank you, Mr. Chairman. Senator Rodriguez: Thank you, Senator. Is there anyone who wishes to provide oral testimony? If not, I'll recognize any senator who would like to put anything on record? Vice-Speaker? Vice-Speaker Terlaje: Does this require then that the retirees who are not currently opting into the Government plan will get deductions from their retirement to cover the health insurance. Senator Espaldon: Does this require that government in court. I'm sorry, the question? Vice-Speaker Terlaje: Since it's making it mandatory that they kind of opt into the government's health plan? Senator Espaldon: No, it does not make it mandatory. Bottom line is this is specific to those government retirees and their survivors who are under Medicare A and B. This would mandate them to enroll or be enrolled in the RAP program. In essence, what's happening right now is we have a lot of these retirees who are now under Medicare. Medicare is their primary insurance. Vice-Speaker Terlaje: Ok, I thought... so not it's not a mandatory thing for those presently not enrolled. Senator Rodriguez: Senator Lee? Chairman, Committee on Health, Tourism, Military Affairs and Senior Citizens Ufisi11a11 Tod11 Guam I Mina' T rwtai Kmittro Na Liheslat11ra11 G11aha11 34th G11am Legislat11re Ran Care Bldg., Suite B1, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (8638) /Facsimile: / senatordrodriguez@gmail.com /

15 SENATOR DENNIS G. RODRIGUEZ, JR. Senator Lee: Thank you, Mr. Chair. I just had one question- having the survivors or the retirees enroll in the RSP would that change any of them or I mean would that change their ability to keep their existing benefits... would it change any of their benefits. Would it change their existing benefits or with that would they gain any benefit from it. Would they gain any benefit from it? Senator Espaldon: They would definitely gain benefit by not reducing their costs for health insurance. They in fact, it might even improve their benefits. Right now, they're overspending is what they're doing out of their own pocket and as a consequence Government of Guam in order to match them or to come for their contribution also is now overspending and so the benefits for the RSP really is because Medicare is the primary insurance for these retirees. The RSP is basically the secondary so even right now if they're enrolled in the present plan at PPO 1500, Medicare is still the primary and this just basically says- Well, you don't have to pay for your secondary insurance. Medicare doesn't cover and RSP is included already in the Government of Guam health plan so it would cost the government nothing and it would cost the retirees nothing. So actually the benefit to both the government and the retiree is that they don't have to pull out of their pocket anymore. Senator Lee: And you mentioned a $3.4 million in savings. Potential savings? Senator Espaldon: Potential minimum because those are... that's the numbers that garnered through the Government of Guam Retirement fund because in order to be reimbursed for their benefits from Medicare, they have to report to the government of Guam retirement fund. So we have identified that number at present and again when you add it all up and take a look at what it would save the government, it's about 3.3 million dollars. That's also in BBMR's comments on this bill. Thank you Mr. Chairman. Senator Rodriguez: The committee will go ahead and keep the record open for Bill No and will continue to accept any written testimony that the public may have until such time the committee closes the committee report. Thank you very much. The time now is 9am. The public hearing is adjourned. III. Fiscal Note: Attached III. FINDINGS AND RECOMMENDATIONS The Committee on Health, Tourism, Military Affairs and ;;enior Citizens, hereby reports out Bill No (COR) with the recommendation to :13 Jip,., (Jrf- 6n7. I Chairman, Committee on H ealth, Tourism, Military Affairs and Senior Citizens Ufisi11a11 Tod11 G11a111 I Mi11a' T re11tai K11Jttrv Na Liheslat11ra11 G11Jha11 34th Guam Legislature Ran Care Bldg., Suite Bl, 761 S. Marine Corps Drive, Tamuning, Guam Telephone: TODU (8638) /Facsimile: / senatordrodriguez@gmail.com /

16 I MINA' TRENTAJ KUATTRO NA LIHESLATURAN GU4HAN 2018 (SECOND) REGULAR SESSION Bill No. 2_ 1 -f'!? -34(. l:iz-j Introduced by: AN ACT TO AMEND ITEMS (a) AND (b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM.,_, = c:o s BE IT ENACTED BY THE PEOPLE OF GUAM: Section 1. Item (a) of 4301 of 4GCA is amended to read:.t::: "(a) I Maga 'lahi (the Governor) is au. thorized to enter contracts and reject " proposals, with the \.vritten concurrence of the Speaker of I Liheslaturan Guahan (the Guam Legislature) or the Chief Justice of the Supreme Court of Guam whose consents may be withheld in their sole discretion, with one ( 1) or more insurance companies, authorized to do business in Guam, for group insurance, including, but not limited to, hospitalization, medical care, life, and accident, for all employees or separate groups of employees, and foster children, of the government of Guam. If the Legislative or Judicial Branches of government elect to enter into separate contracts for their employees as authorized in 430l(c), I Maga'lahi shall obtain the written concurrence of the Branch electing to remain with the Executive Branch on or before March 1st of each year [before the group insurance contract is entered into or a proposal rejected]. Notwithstanding any authority granted in each entity's enabling legisl(:ltion to procure separate health insurance coverage, all entities in the Executive Branch, including autonomous and semi-autonomous agencies, public corporations and authorities, shall pmiicipate in the Government of Guam Group Health Insurance Program. The ~ i

17 1 government shall not be construed as an agent of any insurance company in negotiating 2 or administering this group insw ance program. Health benefits provided under this 3 authority may be self-funded and administered by a third party if it is detennined to be 4 cost-effective." s Section 2. Item (b) of 4301 of 4GCA is amended to read: 6 "(b) All pai1icipation by employees in such contracts of insurance shall be on a 7 voluntary basis. All retired employees and survivors of a retired employee who are 8 enrolled in Medicare Parts A&B, and who participate by electing either Class I or Class 9 II coverage. shall enroll in the Retiree Supplemental Plan. Effective in the next contract 10 following the enactment of this subparagraph, the government's contribution for health 11 and dental insurance shall be unifonn within each class (including separate classes and 12 rates for retired employees and their survivors) for all competing plans, and shall not be 13 less than fifty percent (50%) of the lowest premium for a single employee, except that 14 the government shall increase the contributions it makes on behalf of a retired employee 1s or survivor of a retired employee so that the retired employee or the survivor of a retired 16 employee contributes no more than an active employee who is otherwise in the same 17 class. The government contribution for a retired employee or survivor of a retired 18 employee shall not exceed three (3) times the lowest premium for a single active 19 employee while maintaining the current level of government contribution. 20 Notwithstanding any other provision of this Section to the contrary, the government of 21 Guam shall cover the full cost of insurance coverage for foster children, and such 22 coverage shall require no co-payments nor deductibles for the foster children insured 23 pursuant to this Section." 24 Section 3. Effective date. This Act shall be effective upon enactment.

18 Senator Thomas C. Ado. Vice Chairperson Speaker Benjamin J.F. Cruz. Vic e Speol'.er Therese M. Terlaje. $enator Frank B. Aguon. Jt.. Senator Telena C. Nelson, : " ii. -.::..; _.:,_ COMMITTEE ON RULES SENATOR REGINE BISCOE LEE, C~HAIR SIKRITARIAN LIHESLATURAN GUAHAN I MINA'TRENTAI KUATIRO NA UHESLATURAN GUAHAN LEGISLATIVE SECRETARY 34m GUAM LEGISLATURE PRE-REFERRAL CHECKLIST Senator Dennis G. Rodriguei. Jr.. Senator Joe S. San Agustin, Senator Michael F.Q. Son Nicolas. Senator James v. Espaldon, Senator Mory Camacho Torres. BILL NO {COR) AN ACT TO AMEND ITEMS (a) AND {b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. Introduced bv: James V. EsDaldon, B.J.F. Cruz (A) Legal Bureau (8) Office of Finance & Budget (OFB) COR Action (1) One subject matter? Notice to Legal Bureau: [SR 6.01(a),2 GCA 2108(a)] )(YES o NO (Return to Prime Sponsor) -. 1\\u~., td?. \t?", ~q&?~l~a.n.. (2) Conform to Standing Rules as to form and style? [SR 6.02(b) and (d), 6.03(d)] }(YES o NO!Return to Prime Soonsorl - ' (1) Does the 8111 contain appropriations or authorizations for appropriations from any fund ' ' sources? Notice to OFB: C?,.?l_fleted by Legal Bureau:. m:t., fetj. '2l, QOl9J@2~ pm 0 YES )(No. 11i\,A~.!td?. lf1(a)l~'}g1~qlla.r~ (2) Does the Bill contain an ~ authorization to expend government funds? o YES ~NO on/a (3) Does the Biii contain provisions that have potential fiscal Impacts on the government of Guam budget? ')(.YES o NO D N/A Is the fiscal Impact revenue negative to the government of Guam budget? 'l)<;es (Refer to Committee on Appropriations) D NO o N/A ' C-;;mpleted by OFB: r\ae&., ~. Q0,20,<0e 12:4\ rn. Completed by:... ~~~~~~~~~~~~~~ ~~~~~~~~~~~~ GUAM CONGRESS BUILDING 163 CHALAN SANTO PAPA HAG.AT?')A, GUAM Telephone: (671) address: c o rgua1nlcgialaturc@gmail.com Page 1 of 2

19 PRE.. REFERRAL CHECKLIST _ BILL NO (COR) AN ACT TO AMEND.lTEMS (a) AND {b) OF 4301 OF 4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. Introduced b : James V. Es ald9n, B.J.F. Cruz (C) DEBT (1) SR 6.01 (b )(1 )(A) Land, Infrastructure, Building Projects. Capital Improvement Projects )(_NIA DYES o NO (Return to Prime Sponsor) Received by: (Sign re, Date & Time) i:--(-2)-sr_ _ (b-)(-1)-(B-) N- /-A ~.~ 12DI~ l2:, Refinancing of existing _- debt (not less than 2%i _~ - : o YES o NO (Return to Prime Sponsor) '....,... (3)SR 6.01 (b)(2) :1l N/~. - Authorize public debt to o YES {Return to Prime Sponsor) fund operations of agency. : o NO ; instrumentality, public! o Waived (per official state of corporation emergency~ as attached) Completed by: (Si nature, Date & Time) %.20 JOl~ l2:41.m. COR Action For COR Office Use Only Pursuant to COR decision (COR Meeting, April 3, 2017): Completed within five (5) working days? YES D NO ~( fe,\?. 11,20 ~-.8j lfno: Provide letter of explanation {see attached). GUAM CONGRESS BUILDING 16.3 CHALAN SANTO PAPA HAGATl'lA, GUAM Telephone: (671) address: coreuamlcglslaturc@gmail.com r ~. ~ - ~ -. Page 2 of 2

20 Senator Thomas C. Ada. Vice Chairperson Speaker Benjamin J.F. Cruz, Vice Speaker Therese M. Terlaje. Senator Frank B. Aguon, Jr., Senator Telena C. Nelson..;;.""' - ~-~.. t ~ ~~- -. ~ I,ffl i ~ I ~ ~.:_,,.:_~ COMMITTEE ON RULES SENATOR REGINE BISCOE LEE, CHAIR SIKRITARIAN LIHESLATURAN GUAHAN I MINA'TRENTAI KUATTRO NA LIHESLATURAN GUAHAN LEGISLATIVE SECRETARY 34rH GUAM LEGISLATURE Senator Dennis G. Rodriguez, Jr.. Senator Joe S. San Agustin, Senator Michael F.Q. San Nicolas, Senator James V. Espaldon. Senator Mary Camacho Torres. MEMO To: Rennae Meno Clerk of the Legislature March l, 2018 From: Re: Senator Regine Biscoe Lee Chairperson, Committee on Rules Fiscal Notes Buenos yon Hafa adai. Attached, please find the fiscal notes for the following bills: Bill No (COR) Bill No (COR) Please forward the same to Management Information Services (MIS) for posting on our website, For any questions or concerns, please feel free to contact Jean Cordero, Committee on Rules Director, at Thank you for your attention to this important matter. G UAM CONG RESS BU ILD ING 163 C HALAN SANTO PAPA HAG ATNA, GUAM Teleph o n e: (671) address: corguamlegislat u re@gma il.com

21 Bureau of Budget & Management Research Fiscal Note of Bill No (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF 4301OF4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM. Department/Agency Appropriation Infonnation DeptJAgency Affected: Government of Guam JDeptJAgency Head: Department's General Fund (GF) appropriation(s) to date: Department's Other Fund (Specify) appropriation(s) to date: All Special Funds per P.L Total Department/Agency Appropriation(s) to date: Edward J.B. Calvo, Governor $688,559,103 $226,293,421 $914,852,524 FY 2017 Unreserved Fund Balance FY 2018 Adopted Revenues FY 2018 Appro. (P.L } Sub-total: Less appropriation in Bill Total: Fund Source Information or Proposed Appropriation General Fund: $0 $0 so $0 so (Specify Special Fund): Total: $0 $0 so $0 so $0 so $0 so $0 so so. ' Estimated Fiscal Impact of Bill,_,. For Remainder or One Full FY 2018 FY 2019 FY 2020 Fiscal Year (if applicable) General Fund I/ so $0 Special Fund )~ )U Total!L ll )U 19 $0 )U i!! FY 2021 FY 2022 so $0 )U )U ll 0 1. Does the bill contain "revenue generating" provisions? If Yes, see attachment 2. ls amount appropriated adequate to fund the intent of the appropriation? IX I If no, what is the additional amount required? S IX I 3. Does the Bill establish a new program.lagency? If yes, will the program duplicate existing programs/agencies? Is there a federal mandate lo establish the program/agency? 4. Will the enactment of this Bill require new physical facilities? IX I 5. Was Fiscal Note coordinated with the affected dept/agency? Ir no, indicate reason: I I Requested agency comments not received by due date I I Other: NIA NIA NIA IX I Yes I I Yes I I Yes I I Yes I I Yes I I Yes IX/ Yes I I No I I No /XI No I I No /XI No IX/ No I I No Date: MAR-O-l-2018, Jr., Ac~ ing_ J)irestor I

22 BUREAU OF BUDGET AND MANAGEMENT RESEARCH COMMENTS ON BILL NO CCOR) The intent of the proposed legislation is to: 1) require the Legislative and Judicial branches to provide written concurrence to the Executive branch on or before March 1 of each year regarding their intent to be included in the Government of Guam Group Health Insurance Program (GHIP); 2) require all Executive branch departments, to include autonomous and semi-autonomous agencies, public corporations, and authorities to enroll in the Government of Guam GHIP; and 3) mandate all retired employees, and their survivors, who are enrolled in Medicare Parts A&B to enroll in the Retiree Supplemental Plan (RSP). Per local media sources, the author of the proposed legislation establishes a March l deadline for the Legislative and Judicial branches as well as mandates all Executive branch entities to enroll in the Government of Guam GHIP in order to "streamline the process and result in lesser costs to the Government of Guam" by establishing the amount of "prospective enrollees for better rate development by the responding health insurance companies. Because the rates are based on annual negotiations from health care providers, the Bureau is unable quantify if the measure will in fact provide a savings in insurance costs. Additionally, the proposed legislation's intent to mandate all retirees and their survivors to enroll in the RSP may result in a cost savings of approximately $3.4M annually. Per local media sources, the author of the proposed legislation has stated the transition of retirees and their survivors from the Medicare health insurance programs, which is broken into two classes, into the RSP may result in the following savings: Class I - $6, annually; Class II - $12, Per the local media source, there are 399 retirees/survivors on the Medicare Class I plan and 79 retirees/survivors on the Medicare Class II plan, which would likely result in an annual savings of $2,443,221 and $983,626 respectively. ti Page

23 Senator Thomas C. Ada, Vice Chairperson Speaker Benjamin J.F. Cruz, Vice Speaker Therese M. Terlaje, Senator Frank B. Aguon, Jr., SenatorTelena C. Nelson, COMMITTEE ON RU LES SENATOR REGINE BISCOE LEE, CHAIR SIKRITARIAN LIHESLATURAN GUAH~ N I MlNA'TRENTAI KUATTRO NA LIHESLATURA GUAHAN LIGISLATIVE SECRETARY 34TH GUAM LEG SLATURE COMMITTEE REPORT CHECKLIST Part 1 I 1 Senator Dennis G. Rodriguez, Jr., Senator Joe S. San Agustin, Senator Michael F.Q. San Nicolas, Senator James V. Espaldon, Senator Mary C. Torres, BILL NO (COR) AN ACT TO AMEND ITEMS (a) AND (b) OF 4301OF4 GCA, RELATIVE TO THE GOVERNMENT OF GUAM GROUP HEALTH INSURANCE PROGRAM - sponsors: James V. Espaldon, B.J.F. Cruz REFERRED TO: Senator Dennis G. Rodriguez, Jr.. Chairman Cmte on Health, Tourism, Military Affairs & Senior Citizens (1) Requested by COR Date & Time: v'yes D NO (1) Received by COR -.Q YES D NO te.b. 'J.9.., CW\~ Date & Time: ~ \\ :?J',1 Q l'c\. (A) FISCAL NOTE or WAIVER (3) Waived by S:OR o YES../J NO (4) Bill contains appropriations or authorizations for appropriations from any fund sources? o YES f/ NO > < o YES ( 5) Bill contains an authorization to expend government funds? o YES./, NO Date & Time: If YES: (4/5)(a) Funding Availability Note/Waiver (OFB) attached? o YES D NO (Unable to file CMTE Report) (4/5)(b) Funding source identified? 2 GCA o NO (Proceed to (A)(6)) (4/5)(c) Funds available and sufficient? 2 GCA 9101 o YES o NO (Proceed to (A)(6)) ( 6) Restrictions Against Unfunded Appropriations (2 GCA 9101) o Identifies specific alternate funding source o De-appropriates from previous appropriation with available funds and fiscal note o Written certification by CMTE Chair that a situation exists which "threatens the safety, health and welfare of the communitv" If no boxes checked: UNABLE TO PLACE ON SESSION AGENDA 2 GCA 9102 GUAM CONGRESS LD!NG 163 C l!alan SANTO PAPA llagatna, GUAM 969 l0 Tele pho n e: (67 1) J.55 E m a il add ress: co rg u a m legislarurc@grn a il.co m

24 Committee Report Checklist on Bill No (COR) Part 1 I 1 (8) PUBLIC HEARING (1) HEARING NOTICES SR 6.04(a)( l) and 6.04(a)(2), Open Government Law (5 GCA, Ch. 8) J (a) Five (5) working days prior (AL Senators & ALL Media)./ (b) Forty-eight (48) hours prior (ALL Senators & ALL Media) Date and Time of Notice: 'tt~.. ~ '?>D. 2D\~ Q S\:s~ (A.m. Date and Time of Notice: ~(?, ~.CJ, IU)tq; ~\\:\\a ()..m. or (2) Date and Time of Hearing: (4) HEARING WAIVED by Speaker \1\. in case of emergency I SR 6.04(a) ( l) '"""'<;" ~'(. \'J.., '>-tit <t y q,: ~ ~ (3) Location: o YES o NO D N/A Public Hearing Room, Guam Congress Building If YES: Attach memo indicating WAIVER (5) AMENDMENTS or SUBSTITUTIONS BY COMMITTEE SR 6.04(b) If YES: Date and Time: (a) Committee elects to substitute bill?~ o YES NO ( a)(l) Vote sheet affirmative? o YES o NO ( a)(2) Preliminary report filed with COR? SR 6.04(b) (2) o YES o NO ( a)(3) Public Hearing noticed? o YES o NO If YES: SECONDARY PUBLIC HEARING MAY BE (b) Bill materially different after REQUIRED committee amendment or SR 6.04(c) (3) substitution? h o YES NO o YES o NO COR Chair 2

25 Committee Report Checklist on Bill No (COR) Part 1 I 1 {1) Committee Report filed with COR?.J YES o NO Notes: If YES: Date & Time: {1 ){a) Secondary CM~E Report filed with COR? o YES o NO / NIA If NO: UNABLE TO PLACE ON SESSION AGENDA SR 6.04(d)(l) If YES: Date & Time: (2) LAND LEGISLATION (C) COMMITTEE REPORT {a) Bill involves government taking, transfer, purchase, or lepse of land? o YES o NO /J N/ A {a){l) Please indicate on both columns: {i) Type of {ii) Type of entity: transaction: o Government o Taking o Non-government o Transfer o Purchase o Lease {b) Bill involves legislative land rezoning? o YES D NO ~ N/A {b ){ 1) Bill involves legislative rezoning of property zoned Agricultural {A)? o YES o NO 15 N/ A If YES: ATTACH TWO {2) PROPERTY APPRAISALS TO CMTE REPORT SR 6.04(c) (4) 2 GCA 2107(b) If YES: INCLUDE Land Zoning Consideration Report 2 GCA 2110 If YES: INCLUDE Agricultural Consideration Report {Dept. of Agriculture) 2GCA 2110 [Proceed to (b)(2)] {b){2) Proof of Agricultural consideration report reviewed by Guam Land Use Commission? 21 GCf o YES D NO ii N/ A 3

26 Committee Report Checklist on Bill No (COR) Part I 1 (3) G.A.R.R. LEGISLATION SR 6.04(c)(l) 5 GCA and 9303 a) Bill involves approving or If YES: amending Rules and INCLUDE Regulations? Economic Impact Statement o YES o NO d NIA 5 GCA 9301 (d), (e), 9301 (f) (4) COMMITTEE REPORT COMPONENTS (a) Front Paqe Transmittal to Speaker ~ (a)(l) COR Chair SiQnature Line..,6 (b) Title Page..Jf (c) Committee Chair Memo to All Committee s., (d) COR Referral Memorandum. (e) Notice of Public Hearing & Other Correspondence.,( (f) Public Hearing Agenda (D) COMMITTEE REPORT (g) Public Hearing Sign-in Sheet./ (continued) (h) Written Testimonies & Additional Documents D (i) Committee Vote Sheet(s) r/ (j) Committee Report DiQest(s) r/ (k) Bill History (k)(l) Copy of Bill as introduced. u (k)(2) COR Pre-Referral Checklist!!/ (k)(3) Copy of Bill as corrected by Prime Sponsor (if applicable) D (k)(4) Copy of Bill as amended/substituted by Committee lif aoolicablel D Substitute/ Amended Mark-Up Version D Substitute/Amended Word-Version ed to COR? D I (I) Fiscal Note/Waiver and FundinQ Availability Note (OFB (m) Two (2) Property Appraisals (if applicable) (n) Related News Reports (optional) (o) Miscellaneous (optional) (p) Committee Report Checklist(s), /..J CMTE Report duly filed; Available for Placement on d D D D Originals... Single-Sided q Letter Size ~ No Staples/ Paper Clips..i6 Session Agenda COR CHAIR (E) COR Action o CMTE Report non-conforming (~a ture'(jj t e & Time) for acceptance; Return to, Jilli v--..,,- Committee... Q I 1,,JJA f]; j ~ 4--\~~~ ~?>:~ "' \ ~ 4