October 15, 2014

P.O. Box 6578 Tamuning, Guam 96931 Telephone, 16711646-6956 Fax 16711647-3520

Senator Judith T. Won Pat Speaker- 32'' Guam legislature 155 Hessler Place Hagatna, Guam 96910

Re: Government of Guam Health Insurance Program Reporting Requirements

Hafa Adai Speaker Won Pat:

Enclosed herewith is a hard copy and flash drive containing an electronic version of the following Government of Guam Reports as required and mandated by law:

(1) September 2014 Enrollment and Premium Payment Data (Public law No. 32-0681 (21 September 2014 Claims Data

Please contact me at (6711 482-8557, (671) 300-7162 or email ~Uii.!Jl!g):illll1Uii.l~~J;QJ]l should you have any questions or concerns regarding the enclosed reports.

Si~,

~"?-----;;!-~ -fiissa Kinsella Talavera · Sr. Sales Manager

TakeCare Insurance Company

2129

® 'llU."eCare'' TakeCare Insurance Company Med & RX Claims for GOVERNMENT OF GUAM Date of Service From: 10/1/2013 To 9130/2014 Print Date!TJme:10/13/2014 3:11PM

Copyright@ 2011 TakeCare. All rights reserved TC Confidential Page 1 of 1

TakeCare Insurance Company alhkeCare" Monthly Enrollment by Plan· GOVERNMENT OF GUAM Extraction Date From: 1011/20i3to 913012014

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0 Tal..""eCare~ TakeCare Insurance Company Monthly Enrollment by Plan - GOVERNMENT OF GUAM Extraction Date From: 1011/2013 to 9/3012014 Pnnt Date/Time

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0 Tal.."eCare" TakeCare Insurance Company Monthly Enrollment by Plan ~ GOVERNMENT OF GUAM Extraction Date From: 1011/2013 to 9!3012014 Pnnt DatBITII'm:r10/1Cli2014 3'12 PM

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TakeCare Insurance Company 0 Tak--eCare~ Monthly Enrollment by Plan~ GOVERNMENT OF GUAM Extraction Date From: 10/11:2013 to 9/30/20i4 Pnn! DatefTime-i0/13/2014 3· 12 PM

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e Tak--eCare~ TakeCare Insurance Company Monthly Enrollment by Plan~ GOVERNMENT OF GUAM Extraction Date From: 10/112013 to 9/30/2014 Print Date/Time-10/1312014 3:12PM

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8 Tal.."eCaxe TakeCare Insurance Company Monthly Enrollment by Plan w GOVERNMENT OF GUAM Extraction Date From: 1011/2013 to 9/3012014 Prmt Oate!Time·10il3/2014 3·12 PM

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a '18.keCare· T akeCare Insurance Company Monthly Enrollment by Plan - GOVERNMENT OF GUAM Extraction Date From; 1ot112013 to 9130/2014 Prim DatafT!me:l0/1312014 3:12PM

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(STakeCare"

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era.KeCare~

Page 1 of 6

TakeCare Insurance Company Claims By Type of Service • GOVERNMENT OF GUAM Date of Service From Oct 01,2013 to Sep 30,2014 Printed Date/Time: 10/13/2014 3:11:57 PM

TC Confidential Copyright@ 2011 TakeCare. All rights reserved

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Page 2 of 6

TakeCare Insurance Company Claims By Type of Service - GOVERNMENT OF GUAM Date of Service From Oct 01,2013 to Sep 30, 2014 Printed Daterrime: 10/13/2014 3:11:57 PM

TC Confidential Copyright @ 2011 TakeCare. All rights reserved

6) 781.--eCar'e'"

lnpatientMHospita!

Preventive Care ~ Adults

Lab

Inpatient Surgery~Faci!ity

Immunizations ·Well Baby Care (up to 2 yrs, old)

Specialist/Urgent Care Office Visit

Inpatient-Maternity

Prescription Items, Hospital OP

Radiology

Immunizations~ Well Child Care (3 · 17yrs. old)

Surgery Physicians • OP Hospltai/FaclHty

Specialist, Surgery

Immunizations

Surgery FacUlty, Hospital OP

We!! Child Care -Preventive (0 to 4 yrs o!d)

Well Child Care· Preventive (5 to 17 yrs old)

Chemotherapy Agents

!npatient-Prescriptlon Items

Maternity, Office Visit

Chemotherapy, Outpatient Hospital

Inpatient Maternity-Professional

Lab, Hosprtal OP

Surgery Physicians

Birthing Center, Outpatient Ho..:;:pitai/Faci!lty

TakeCare Insurance Company Claims By Type of Service - GOVERNMENT OF GUAM Date of Service From Oct 01, 2013 to Sep 30, 2014 Printed Date!Time: 10/13/2014 3:11:57 PM

$178,398.231

$116,046.95

$82,376.04

$63,965.47]

$62,452.911

$52,606.69

$52,435.30

$44,631.11 i

$44,248.77'

$42,078.86

$39,297.74

$38,937.00:

$32,201.87

$31,675.52

$30,870.12

$27,399.41

$25,316.54

$25,218.78

$22,518.88

$22,486.50

$22,473.92

$21,390.84

$19,628.84

$19,012.38

Urgent Care, after SPM, weekends and ho!idays(99050, 99051) $18,828.63

MR!, PA Required $18,110.12

Hemodialysis ~ OP Professional $17,480.00

Radiation Therapy $16,077.68

CT Scan, PA Required $14,944.23

Inpatient-Hospital Visit~Professiona! $14,716.65

lnpatient~Prosthetics Supplies/Devices/Implants/ {UB Codes only) $14,607.49

Inpatient Surgery Physicians $13,521.73

ER Facility, Emergency $12,890.30

ER Physicians $10,672.08

Nuclear Med1cine $10,583.32

Facillty Supplies, Hospital Outpatient $10,418.87

TC Confidential Page 3 of 6 Copyright @ 2011 TakeCare. All rights reserved

e TakeCare'" !njectables and other medications

Chemotherapy

Treatment/Observation Room, Hospital Outpatient

Surgery Physicians, Outpatient Hospital

Ultrasound, Specialist

Inpatient Emergency Room, Admitted

!nsert/AMV/IUD/BC Implant

Professional, Surgery Physicians

Inpatient Lab

Anesthesia - IP

Refraction

Diagnostic, Hospital Outpatient

Maternity - OP Professional

Diagnostic

Inpatient-Hospital, PA required

Airfare

Anesthesia - Faci!ity!OP Hosp Off-Island

Radiology, Hospital OP

Specialist, Diagnostic

Physical Therapy

Maternity, Diagnostic

Well Child Care- Preventive (2 to iS yrs old)

Home Health

Inpatient CT Scan, PA required

Inpatient Radiology

Inpatient Diagnostic

Inpatient Non-covered Benefit

Anesthesia - OP Hospital

Facility Supplies

ER, CT Scan, PA required

MRI, Hospital Outpatient

TakeCare Insurance Company Claims By Type of Service - GOVERNMENT OF GUAM Date of Service From Oct 01,2013 to Sep 30,2014 Printed DatefTime: 10/13/2014 3:11 :57 PM

$10,359.85

$10,208.42

$9,650.63

$9,628.16

$9,171.19

$8,760.25!

$8,017.36

$7,495.87

$7AT1.46

$7,396.83

$6,962.66

$6,696.67

$5.844.32

$5,675.40

$5,627.27

$5,079.06

$4,933.94

$4.792.45

$3,923.95

$3,794.30

$3,658.82

$3,604.24

$3,569.65

$3,108.59

$3,097.23

$2,641.52

$2,275.31

$2,096.00

$2,041.53

$1,949.90

$1,921.81

Prosthetic Supp!ies/Devicesllmplants, Outpatient Hospital $1.889.53

Miscellaneous, Facility- Hospital OP $1,788.00

Mental Health - Professional $1,582.45

External Breast Prosthesis (WHRCA) -Surgery $1,500.00

ER, Ambulance $1,491.76

TC Confidential Page 4 ol6 Copyright @ 2011 TakeCare. All rights reserved

e rakeeare'M Chiropractic

tnjectible Contraceptives

Prescriptions

Labor and Delivery - OP Hospital!F aci!ity

Radiology, TC Modifier

TakeCare Insurance Company Claims By Type of Service - GOVERNMENT OF GUAM Date of Service From Oct 01, 2013 to Sep 30, 2014 Printed DatefTime: 10/13/2014 3:11:57 PM

$1,381.00

$1,237.52

$1.214.61

$1,200.00

$1,192.63

Foot Care {GG & FED 2002 w! Diabetes/PVD Ox ONLY) $1,136.40

Lodging $1.115.40

Hearing Screening $1,056.73

Inpatient Orthotics excluding (LSO) $1,024.75

Faci!ty Supplies, Outpatient Hospital/Facility $933.03

DME, Home Health $870.00

Ultrasound $836.48

Consults $818.94

Radiology, ER, 26 Modifier $783.08

Hospital Visit • Professional. Outpatient Hospita!/Facihty $758.88

Inpatient Ultrasound $735.59

External Breast Prosthesis (WHCRA) - Surgery $710.40

Hemodialysis ~ IP & OP Professional $626.76

Labor and Delivery, Outpatient Hospital $619.87

Inpatient tnjectables and other medications $548.44

Radiology, 26 Modifier $527.92

ER, Hospital Visit $441.60

Hospital Visit • Professional, Outpatient Hospital $427.48

MR!. 26 Modifier, Hosp OP $423.75

lntra·Ocular Lens $349.65

Intra-Ocular Lens, Outpatient Hospital/Facility $330.00

TC Confidential Page 5 ol6 Copyright @ 2011 TakeCare. Atl rights reserved

erakeeare~ TakeCare Insurance Company Claims By Type of Service - GOVERNMENT OF GUAM Date of Service From Oct 01, 2013 to Sep 30, 2014 Printed DatefTime: 10/13/2014 3:11 :57 PM

···-----·~-·····----~----. --"~·---~----·---·- --··-----·

Claims By Type of Service - HSA Claims By Type of Service - PPO

4%

• Preventive Care~ Adults •Inpatient-Hospital Wlmmunizations ·Well Child Care (3 ·17yrs. old) wlmmunizations ·Well Baby Care (up to 2 yrs. old) • Well Child Care· Preventive (5 to 17 yrs old) • Others

·--····· ---··············--·-·· ..

• Office Visit 81npatient-Hospital • Preventive Care - Adults • Lab a Inpatient Surgery-Facility • Others

10%

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TC Confidential Page 6 of 6 Copyright @ 2011 TakeCare. All rights reserved

(()) TakeCa:re"·

Page 1 of 1

TakeCare Insurance Company Large Claims Report (~$25,000) • GOVERNMENT OF GUAM Start Date: 10/1/2013; End Dale: 9/30/2014 Print Date!Time

TC Confidential

erakeeare~ TakeCare Insurance Company GOVERNMENT OF GUAM- Top 10 Drug Utilization Start Date: 10/1/2013; End Date: 9/30/2014 Print Date!Time:10/1 3/2014 3:11 PM

-··-------------~··

GOVERNMENT OF GUAM- Top 10 Drug Utilization

Page 1 of 1

• SOURIS

• ENBREL

• NEULASTA

•LANTUS

• PERJETA

• PEGASYS

•JANUVIA

• LANTUS

"CELEBREX

• DIOVAN

Copyright @ 2011 TakeCare. All rights reserved TC Confidential

-·l I

INJ lOMG/Ml

INJ SOMG/ML

INJ 6MG/0.6M

I INJSOLOSTAR

INJ 420/14Ml I

INJ I TAB lOOMG

I INJ 100/ML I I

CAP 200MG

J TAB 160MG

e Thl.'"eCa.re'' TakeCare Insurance Company Gym Membership Expenses Paid GOVERNMENT OF GUAM Start Date: 1011/2013; End Date: 9/30/2014 Print Oate!Time:10/14/20i4 2:44PM

0Tal:eCare TakeCare Insurance Company Total Monthly Premiums Paid~ GOVERNMENT OF GUAM Start Date: 10/112013; End Date: 9130/2014

1 PM

Copyright@ 2011 TakeCare. A!l rights reserved TC Confidential Page 1 of 1

9TakeCare~ TakeCare Insurance Company Claims TAT for Government of Guam Parameters: Start Date: 10/1/2013, End Date: 9130/2014 Print Date!Time:1 0/13/2014 3:12 PM

Page 1 of 2

Days Claim Count % Cummulative Cum.%

5 6 7 8 9 1

1

1 14 15 16 17 18 19 20

28 29 30 31

8 151 146 181 164 192

0. 0,

1.78% 1.61% 1.88°1< ?

759 923 1115 1341

!4 1 10

167 ,( 1 07

212 08°1< 2 19 180 7' 2199 200 )6' 2399 238 34' 2637 197 1.93% 2834 257 2.52°1< 3091 276 2.71% 3367

681 339 247 239 163

59

2.42%

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495 565 6 632

7949 8196 8435

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2' 0'

5.67% 7.45%

1: '

'3% 19.81%

.58% :.54% ,RR%

27.81% 30.33%

' Rf;

>.13

'4.67~ 7s.nno;_ 80.42% 82.77%

.37% ' ~~OJ,

77 l8 0.76' 9 !1.41%

45 46 47

35 0.34% 9908 14 0.14% 9922 34 9956

Copyright @ 2011 TakeCare. All rights reserved TC Confidential

97.22% 97.36% 97.69%

40 Days

95%

48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 75 76 77 80 81 83 85 88 91

105 112 126 127 129 141 146 163 169 173 177 178 181 182 215

Totals:

Page 2 of 2

TakeCare Insurance Company Claims TAT for Government of Guam Parameters: Start Date: 1011/2013, End Date: 9/30/2014 Print Daterrime·10/13/2014 3·12 PM

7 0.07% 9963 28 0.27% 9991 6 0.06% 9997 4 0.04% 10001 9 0.09% 10010 7 0.07% 10017 13 0.13% 10030 12 0.12°/o 10042 3 0.03% 10045 13 0.13% 10058 9 0.09% 10067 3 0.03% 10070 7 0.07% 10077 1 0.01% 10078 6 0.06°/o 10084

30 0.29% 10114 3 0.03% 10117 4 0.04% 10121 8 0.08% 10129 3 0.03% 10132 3 0.03°/o 10135 6 0.06% 10141 3 0.03% 10144 4 0.04% 10148 5 0.05% 10153 2 0.02% 10155 6 0.06% 10161 1 0.01% 10162 < 0.01% 10163 ' 1 0.01% 10164 3 0.03% 10167 2 0.02% 10169 2 0.02% 10171 i 0.01% 10172 1 0.01% 10173 1 0.01°/o 10174 2 0.02% 10176 1 0.01% 10177 1 0.01% 10178 1 0.01% 10179 1 0.01 o/o 10180 1 0.01% 10181 1 0.01% 10182 3 0.03% 10185 1 0.01% 10186 1 0.01% 10187 2 0.02% 10189 1 0.01% 10190 1 0.01% 10191

10191

Copyright @ 2011 TakeCare. All rights reserved TC Confidential

97.76% 98.04% 98.10% 98.14% 98.22% 98.29% 98.42% 98.54% 98.57% 98.69% 98.78% 98.81% 98.88°/o 98.89% 98.95% 99.24% 99.27% 99.31% 99.39% 99.42% 99.45% 99.51% 99.54% 99.58% 99.63% 99.65% 99.71% 99.72% 99.73% 99.74% 99.76% 99.78% 99.80% 99.81% 99.82% 99.83% 99.85% 99.86% 99.87% 99.88% 99.89% 99.90% 99.91% 99.94% 99.95% 99.96% 99.98% 99.99%

100.00%