AHCA CONTRACT NO. FA904 AMENDMENT NO. 6
Exhibit 10.15
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WellCare of Florida, Inc.
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d/b/a Staywell Health Plan of Florida
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AHCA CONTRACT NO. FA904
AMENDMENT NO. 6
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency” and WELLCARE OF FLORIDA, INC. D/B/A STAYWELL HEALTH PLAN OF FLORIDA, hereinafter referred to as the “Vendor” or “Health Plan”, is hereby amended as follows:
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1.
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Effective August 1, 2011, Attachment I, Scope of Services, Capitated Health Plans, is hereby amended to include Attachment I, Exhibit 1-A, Revised Maximum Enrollment Levels, attached hereto and made a part of the Contract. All references in the Contract to Attachment I, Exhibit I, shall hereinafter also refer to Attachment I, Exhibit 1-A, as appropriate.
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2.
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Attachment II, Core Contract Provisions, Section XVI., Terms and Conditions, is hereby amended to include Item GG. as follows:
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GG. Work Authorization Program
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The immigration Reform and Control Act of 1986 prohibits employers from knowingly hiring illegal workers. The Vendor shall only employ individuals who may legally work in the United States – either U.S. citizens or foreign citizens who are authorized to work in the U.S. The Vendor shall use the U.S. Department of Homeland Security’s E-Verify Employment Eligibility Verification system to verify the employment eligibility of:
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all persons employed by the Vendor, during the term of this Contract, to perform employment duties within Florida; and,
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all persons (including subcontractors) assigned by the Vendor to perform work pursuant to this Contract.
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The Vendor shall include this provision in all subcontracts it enters into for the performance of work under this Contract.
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Unless otherwise stated, this amendment is effective upon execution by both parties.
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All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the Contract.
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This amendment and all its attachments are hereby made a part of the Contract.
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This amendment cannot be executed unless all previous amendments to this Contract have been fully executed.
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Amendment No. 6, Page 1 of 2
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WellCare of Florida, Inc.
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d/b/a Staywell Health Plan of Florida
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IN WITNESS WHEREOF, the Parties hereto have caused this five (5) page amendment (including all attachments) to be executed by their officials thereunto duly authorized.
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WELLCARE OF FLORIDA, INC., D/B/A
STAYWELL HEALTH PLAN OF FLORIDA
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STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION
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SIGNED
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SIGNED
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BY:
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/s/Xxxxxxxxx Xxxxxx
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BY:
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/s/ Xxxxxxxxx Xxxxx | |||||
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NAME:
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Xxxxxxxxx Xxxxxx
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Name:
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Xxxxxxxxx Xxxxx
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TITLE:
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President, Florida & Hawaii Division
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TITLE:
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Secretary
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DATE:
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6/29/11
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DATE:
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6/30/11
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List of Attachments/Exhibits included as part of this amendment:
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Specify
Type
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Letter/
Number
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Description
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Attachment I
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Exhibit 1-A
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Revised Maximum Enrollment Levels (3 Pages)
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Amendment No. 6, Page 2 of 2
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WellCare of Florida, Inc.
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d/b/a Staywell Health Plan of Florida
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ATTACHMENT I
EXHIBIT 1-A
REVISED MAXIMUM ENROLLMENT LEVELS
Maximum enrollment levels and Health Plan provider numbers associated with the counties and populations served. Exhibit 2-NR-B provide the capitation rate tables respective to the areas of operation listed below.
A. Non-Reform
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 3 Counties: Hernando, Sumter
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Effective Date: 09/01/09
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County
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Enrollment Level
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Provider Number
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Hernando
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15,000
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015016901
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Sumter
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4,500
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015016916
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 5 Counties: Pasco, Pinellas
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Effective Date: 09/01/09
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County
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Enrollment Level
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Provider Number
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Pasco
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7,000
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015016903
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Pinellas
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15,000
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015016904
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 6 Counties: Hillsborough, Manatee, Polk
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Effective Date: 09/01/09
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County
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Enrollment Level
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Provider Number
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Hillsborough
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28,000
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015016902
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Manatee
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12,000
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015016912
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Polk
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25,000
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015016905
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AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 1 of 3
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WellCare of Florida, Inc.
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d/b/a Staywell Health Plan of Florida
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 7 Counties: Orange, Seminole, Osceola, Brevard
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Effective Date: 09/01/09
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County
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Enrollment Level
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Provider Number
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Orange
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38,000
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015016906
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Seminole
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6,000
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015016908
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Osceola
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12,000
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015016907
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Brevard
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14,000
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015016913
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 8 Counties: Xxx, Sarasota, Charlotte
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Effective Date: 09/01/09, and 08/01/11 Charlotte
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County
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Enrollment Level
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Provider Number
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Xxx
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15,000
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015016911
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Sarasota
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6,000
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015016914
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Charlotte
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27,000
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TBD
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 9 Counties: Palm Beach, St. Lucie, Indian River
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Effective Date: 09/01/09, and 08/01/11 Indian River
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County
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Enrollment Level
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Provider Number
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Palm Beach
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15,000
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015016910
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St. Lucie
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4,500
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015016915
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Indian River
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10,500
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TBD
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 2 of 3
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WellCare of Florida, Inc.
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d/b/a Staywell Health Plan of Florida
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 10 Counties: Broward
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Effective Date: 09/01/09
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County
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Enrollment Level
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Provider Number
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Broward
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25,000
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015016900
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 11 Counties: Miami-Dade
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Effective Date: 09/01/09
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County
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Enrollment Level
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Provider Number
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Miami-Dade
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25,000
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015016909
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 3 of 3
