AMENDMENT #1
Exhibit
10.4
AMENDMENT
#1
TO
THE MEDICAL SERVICES CONTRACT BETWEEN THE FLORIDA HEALTHY KIDS CORPORATION
AND
HEALTHEASE OF FLORIDA, INC. AND WELLCARE HMO, INC.
THIS
AMENDMENT #1 is made and entered into this ^
I
day of
November, by and between Florida Healthy Kids Corporation (PHKC) and HEALTHEASE
OF FLORIDA, INC. AND WELLCARE HMO, INC. hereinafter collectively referred
to as
INSURER.
1.
In
accordance with Sections 3-16 and 3-17 of the current Medical Services Contract
between FHKC and INSURER dated October 1, 2005 (Contract), it is agreed by
the
parties that Exhibit A, Sections I is amended to read:
I.
Premium Rate
The
Comprehensive Medical Care Services premium for the coverage period December
1,
2006 through September 30, 2007 shall be as follows:
|
HEALTHEASE
COUNTIES
|
||||
|
Per
Enrollee Per Month:
|
||||
|
CITRUS
|
$
|
97.01
|
||
|
XXXXX
|
$
|
114.37
|
||
|
ESCAMBIA
|
$
|
101.56
|
||
|
HIGHLANDS
|
$
|
112.05
|
||
|
JEFFERSON
|
$
|
98.51
|
||
|
LAKE
|
$
|
74.36
|
||
|
MADISON
|
$
|
98.51
|
||
|
XXXXXX
|
$
|
100.61
|
||
|
XXXXXX
|
$
|
92.41
|
||
|
WAKULLA
|
$
|
97.01
|
||
|
STAYWELL
COUNTIES
|
|
|
|
|
|
Per
Enrollee Per Month:
|
||||
|
BREVARD
|
$
|
90.88
|
||
|
BROWARD
|
$
|
96.87
|
||
|
CHARLOTTE
|
$
|
98.51
|
||
|
XXXXXXX
|
$
|
98.51
|
||
|
DESOTO
|
$
|
98.51
|
||
|
HERNANDO
|
$
|
125.92
|
||
|
HILLSBOROUGH
|
$
|
80.26
|
||
|
XXX
|
$
|
96.87
|
||
|
MANATEE
|
$
|
98.51
|
||
|
MIAMI-DADE
|
$
|
96.87
|
||
|
ORANGE
|
$
|
80.26
|
||
|
OSCEOLA
|
$
|
80.26
|
||
|
PALM
BEACH
|
$
|
96.87
|
||
|
PINELLAS
|
$
|
80.26
|
||
|
SARASOTA
|
$
|
98.51
|
||
|
SEMINOLE
|
$
|
80.26
|
||
FHKC
Rate
Adjustment Amendment 12-06 Page
1
of
3
___
FHKC
TF
INSURER
2.
The
effective date of this Amendment is December 1, 2006. All other provisions
of
Exhibit A and the Contract in its entirety including all other exhibits shall
remain in full force and effect as executed by the parties effective October
1,
2005.
[SIGNATURE
PAGE FOLLOWS]
FHKC
Rate
Adjustment Amendment 12-06
Page
2 of
3
___
FHKC
TF
INSURER
IN
WITNESS WHEREOF, the Parties have caused this Contract, to be executed by
their
undersigned officials as duly authorized.
DONE
this
29th
day of
November,
2006.
|
INSURER:
|
Florida
Healthy Kids Corporation
|
|
/s/
Xxxx X. Xxxxx
|
/s/
Xxxx Xxxx
|
|
Xxxx
X. Xxxxx
President and
CEO
|
Xxxx
X. Xxxx
Excutive
Director
|
|
Subscribed
and sworn to me this 28th
day of November,
2006
|
Subscribed
and sworn to me, this 18th
day of December,
2006
|
|
/s/
Xxxx Xxxxxxxx
Notary
Public
|
/s/
Xxxxx X. Xxxxx
Notary
Public
|
|
4/3/2008
My
Commission Expires
|
11/14/2009
My
Commission Expires
|
|
1.
/s/
Xxx Xxxxxx
Witness
|
1.
/s/
Xxxxx X. Xxxxx
Witness
|
|
Xxx
Xxxxxx
Print
Name
|
Xxxxx
X. Xxxxx
Print
Name
|
|
2.
/s/
Xxxxx Xxxx
Witness
|
2.
/s/
Xxxxxxxx Xxxxx
Witness
|
|
Xxxxx
Xxxx
Print
Name
|
Xxxxxxxx
Xxxxx
Print
Name
|
|
/s/
Xxxxxxxx Xxxxx
Reviewed
by: Xxxxxxxx Xxxxx 12/1/2006
Director
of External Affairs
|
|
|
/s/
Xxxxxxxx Xxxxx
Reviewed
by: Xxxxxxxx Xxxxx 12/11/2006
Corporate
Counsel, FL Bar #460500
|
FHKC
Rate
Adjustment Amendment 12-06
Page
3 of
3
___
FHKC
TF
INSURER
