AHCA CONTRACT NO. FA904 AMENDMENT NO. 6
Exhibit 10.15
|
WellCare of Florida, Inc.
|
Medicaid HMO Non-Reform Contract
|
|
|
d/b/a Staywell Health Plan of Florida
|
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:
|
1.
|
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.
|
|
2.
|
Attachment II, Core Contract Provisions, Section XVI., Terms and Conditions, is hereby amended to include Item GG. as follows:
|
|
GG. Work Authorization Program
|
|
|
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:
|
|
Ø
|
all persons employed by the Vendor, during the term of this Contract, to perform employment duties within Florida; and,
|
|
|
Ø
|
all persons (including subcontractors) assigned by the Vendor to perform work pursuant to this Contract.
|
|
The Vendor shall include this provision in all subcontracts it enters into for the performance of work under this Contract.
|
|
|
Unless otherwise stated, this amendment is effective upon execution by both parties.
|
|
|
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the Contract.
|
|
|
This amendment and all its attachments are hereby made a part of the Contract.
|
|
|
This amendment cannot be executed unless all previous amendments to this Contract have been fully executed.
|
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Amendment No. 6, Page 1 of 2
|
WellCare of Florida, Inc.
|
Medicaid HMO Non-Reform Contract
|
|
|
d/b/a Staywell Health Plan of Florida
|
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.
|
WELLCARE OF FLORIDA, INC., D/B/A
STAYWELL HEALTH PLAN OF FLORIDA
|
STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION
|
|||||||
|
SIGNED
|
SIGNED
|
|||||||
|
BY:
|
/s/Xxxxxxxxx Xxxxxx
|
BY:
|
/s/ Xxxxxxxxx Xxxxx | |||||
|
NAME:
|
Xxxxxxxxx Xxxxxx
|
Name:
|
Xxxxxxxxx Xxxxx
|
|
|
TITLE:
|
President, Florida & Hawaii Division
|
TITLE:
|
Secretary
|
|
|
DATE:
|
6/29/11
|
DATE:
|
6/30/11
|
List of Attachments/Exhibits included as part of this amendment:
|
Specify
Type
|
Letter/
Number
|
Description
|
||
|
Attachment I
|
Exhibit 1-A
|
Revised Maximum Enrollment Levels (3 Pages)
|
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Amendment No. 6, Page 2 of 2
|
WellCare of Florida, Inc.
|
Medicaid HMO Non-Reform Contract
|
|
|
d/b/a Staywell Health Plan of Florida
|
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
|
Area 3 Counties: Hernando, Sumter
|
|||
|
Effective Date: 09/01/09
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Hernando
|
15,000
|
015016901
|
|
|
Sumter
|
4,500
|
015016916
|
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 5 Counties: Pasco, Pinellas
|
|||
|
Effective Date: 09/01/09
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Pasco
|
7,000
|
015016903
|
|
|
Pinellas
|
15,000
|
015016904
|
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 6 Counties: Hillsborough, Manatee, Polk
|
|||
|
Effective Date: 09/01/09
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Hillsborough
|
28,000
|
015016902
|
|
|
Manatee
|
12,000
|
015016912
|
|
|
Polk
|
25,000
|
015016905
|
|
AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 1 of 3
|
WellCare of Florida, Inc.
|
Medicaid HMO Non-Reform Contract
|
|
|
d/b/a Staywell Health Plan of Florida
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 7 Counties: Orange, Seminole, Osceola, Brevard
|
|||
|
Effective Date: 09/01/09
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Orange
|
38,000
|
015016906
|
|
|
Seminole
|
6,000
|
015016908
|
|
|
Osceola
|
12,000
|
015016907
|
|
|
Brevard
|
14,000
|
015016913
|
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 8 Counties: Xxx, Sarasota, Charlotte
|
|||
|
Effective Date: 09/01/09, and 08/01/11 Charlotte
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Xxx
|
15,000
|
015016911
|
|
|
Sarasota
|
6,000
|
015016914
|
|
|
Charlotte
|
27,000
|
TBD
|
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 9 Counties: Palm Beach, St. Lucie, Indian River
|
|||
|
Effective Date: 09/01/09, and 08/01/11 Indian River
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Palm Beach
|
15,000
|
015016910
|
|
|
St. Lucie
|
4,500
|
015016915
|
|
|
Indian River
|
10,500
|
TBD
|
|
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 2 of 3
|
WellCare of Florida, Inc.
|
Medicaid HMO Non-Reform Contract
|
|
|
d/b/a Staywell Health Plan of Florida
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 10 Counties: Broward
|
|||
|
Effective Date: 09/01/09
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Broward
|
25,000
|
015016900
|
|
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
|
Area 11 Counties: Miami-Dade
|
|||
|
Effective Date: 09/01/09
|
|||
|
County
|
Enrollment Level
|
Provider Number
|
|
|
Miami-Dade
|
25,000
|
015016909
|
|
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 3 of 3
