AHCA CONTRACT NO. FA905 AMENDMENT NO. 6
Exhibit 10.16
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HealthEase of Florida, Inc.
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Medicaid HMO Non-Reform Contract
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AHCA CONTRACT NO. FA905
AMENDMENT NO. 6
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency” and HEALTHEASE OF FLORIDA, INC., 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 1, 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. FA905, Amendment No. 6, Page 1 of 2
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HealthEase of Florida, Inc.
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Medicaid HMO Non-Reform Contract
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IN WITNESS WHEREOF, the Parties hereto have caused this six (6) page amendment (including all attachments) to be executed by their officials thereunto duly authorized.
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HEALTHEASE OF FLORIDA, INC.
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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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6/30/2011 |
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 (4 Pages)
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA905, Amendment No. 6, Page 2 of 2
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HealthEase of Florida, Inc.
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Medicaid HMO Non-Reform Contract
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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 1 Counties: Santa Xxxx
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Effective Date: 08/01/11
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County
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Enrollment Level
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Provider Number
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Santa Xxxx
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31,500
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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 2 Counties: Calhoun, Gadsden, Xxxxxxxxx, Xxxx, Liberty, Madison, Wakulla
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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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Xxxxxxx
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800
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015019340
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Gadsden
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3,500
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015019315
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| Jefferson | 1,000 | 015019318 | |
| Xxxx | 7,000 | 015019320 | |
| Liberty | 400 | 015019342 | |
| Madison | 1,500 | 015019322 | |
| Wakulla | 1,000 | 015019336 | |
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 1 of 4
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HealthEase of Florida, Inc.
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Medicaid HMO Non-Reform Contract
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 3 Counties: Citrus, Xxxx, Xxxxxx, Xxxxxx
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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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Citrus
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7,500
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015019309
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Lake
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7,000
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015019319
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Xxxxxx
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20,000
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015019323
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Xxxxxx
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6,000
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015019329
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See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 4 Counties: Xxxxx, Volusia
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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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Xxxxx
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55,000
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015019313
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Volusia
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15,000
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015019335
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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 | 6,000 | 015019302 | |
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Pinellas
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9,000
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015019303 | |
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 2 of 4
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HealthEase of Florida, Inc.
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Medicaid HMO Non-Reform Contract
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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: Highlands, 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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| Highlands | 3,000 | 015019317 | |
| Hillsborough | 18,000 | 015019300 | |
| Manatee | 6,000 | 015019301 | |
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Polk
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10,000 | 015019304 | |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 7 Counties: Brevard, Orange, Osceola, Seminole
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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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| Brevard | 14,000 | 015019308 | |
| Orange | 25,000 | 015019327 | |
| Osceola | 8,000 | 015019328 | |
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Seminole
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4,000 | 015019333 | |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
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Area 8 Counties: Sarasota
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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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Sarasota
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3,000
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015019332
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 3 of 4
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HealthEase of Florida, Inc.
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Medicaid HMO Non-Reform Contract
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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: Xxxxxx, Palm Beach
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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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| Xxxxxx | 5,000 | 015019324 | |
| Palm Beach | 10,500 | 015019339 | |
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 | 13,500 | 015019337 | |
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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015019338
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REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 4 of 4
