AHCA CONTRACT NO. FA971 AMENDMENT NO. 1
Back to 10-K | Exhibit 10.38.a | |
AMENDMENT NO. 1
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. | Standard Contract, Section III., Item B., Contract Managers, sub-item 2., is hereby amended to revise the Vendor’s Contract Manager’s information as follows: |
Xxxxxx Xxxxxxxxx
WellCare of Florida, Inc.
d/b/a Staywell Health Plan of Florida
0000 Xxxxxxxxx Xxxx
Xxxxxxxxxxx 0
Xxxxx, XX 00000
(000) 000-0000
2. | Effective November 1, 2012, Attachment I, Scope of Services, Capitated Health Plans, is hereby amended to include Attachment I, Exhibit 1-A, Maximum Enrollment Levels, attached hereto and made a part of this Contract. All references in this Contract to Attachment I, Exhibit 1, shall hereinafter also refer to Attachment I, Exhibit 1-A, as appropriate. |
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 this Contract.
This amendment and all its attachments are hereby made a part of this Contract.
This amendment cannot be executed unless all previous amendments to this Contract have been fully executed.
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AHCA Contract No. FA971, Amendment No. 1, Page 1 of 2
Back to 10-K | Exhibit 10.38.a | |
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.
WELLCARE OF FLORIDA, INC., D/B/A STAYWELL HEALTH PLAN OF FLORIDA | STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION | |
SIGNED BY: /s/ Xxxxxxxxx Xxxxxx | SIGNED BY: /s/ Xxxxxxxxx Xxxxx | |
NAME: Xxxxxxxxx Xxxxxx | NAME: Xxxxxxxxx Xxxxx | |
TITLE: President, FL & HI Division | TITLE: Secretary | |
DATE: 11-6-2012 | DATE: 11/16/12 | |
List of Attachments included as part of this amendment:
Specify Type | Letter/ Number | Description |
Attachment I | Exhibit I-A | Maximum Enrollment Levels (4 Pages) |
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AHCA Contract No. FA971, Amendment No. 1, Page 2 of 2
WellCare of Florida, Inc. d/b/a StaywellHealth Plan of Florida | Medicaid Non-Reform HMO Contract | |
ATTACHMENT I
EXHIBIT 1-A
MAXIMUM ENROLLMENT LEVELS
Maximum enrollment levels and Health Plan provider numbers associated with the counties and populations served. Exhibit 2-NR provides the capitation rate tables respective to the areas of operation listed below.
A. | Non-Reform |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 2 Counties: Franklin, Taylor
Effective Date: 11/01/12 | ||
County | Enrollment Level | Provider Number |
Franklin | 1,083 | TBD |
Xxxxxx | 2,516 | TBD |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 3 Counties: | Hernando, Sumter, Columbia, Xxxxxxxx, Xxxxx, Gilchrist, Hamilton, Lafayette, Levy, Suwannee, Union |
Effective Dates: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Hernando | 15,000 | 15016901 |
Sumter | 4,500 | 15016916 |
Columbia | 8,287 | 15016922 |
Effective Dates: 11/01/12 | ||
Bradford | 3,032 | TBD |
Dixie | 1,928 | TBD |
Xxxxxxxxx | 1,644 | TBD |
Xxxxxxxx | 1,934 | TBD |
Lafayette | 646 | TBD |
Levy | 4,927 | TBD |
Suwannee | 5,346 | TBD |
Union | 1,483 | TBD |
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AHCA Contract No. FA971, Attachment I, Exhibit 1-A, Page 1 of 4
WellCare of Florida, Inc. d/b/a StaywellHealth Plan of Florida | Medicaid Non-Reform HMO Contract | |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 4 Counties: St. Xxxxx, Flagler
Effective Date: 09/01/12 | ||
County | Enrollment Level | Provider Number |
St. Xxxxx | 8,300 | 15016920 |
Flagler | 7,400 | 15016923 |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 5 Counties: Pasco, Pinellas
Effective Date: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Pasco | 7,000 | 15016903 |
Pinellas | 15,000 | 15016904 |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 6 Counties: Hillsborough, Manatee, Xxxx, Xxxxxx
Effective Date: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Hillsborough | 28,000 | 15016902 |
Manatee | 12,000 | 15016912 |
Polk | 25,000 | 15016905 |
Xxxxxx | 4,100 | 15016921 |
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AHCA Contract No. FA971, Attachment I, Exhibit 1-A, Page 2 of 4
WellCare of Florida, Inc. d/b/a StaywellHealth Plan of Florida | Medicaid Non-Reform HMO Contract | |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 7 Counties: Orange, Seminole, Osceola, Brevard
Effective Date: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Orange | 38,000 | 15016906 |
Seminole | 6,000 | 15016908 |
Osceola | 12,000 | 15016907 |
Brevard | 14,000 | 15016913 |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 8 Counties: DeSoto, Lee, Sarasota, Charlotte, Glades, Xxxxxx
Effective Dates: 09/01/12 | ||
County | Enrollment Level | Provider Number |
DeSoto | 4,100 | 15016919 |
Xxx | 15,000 | 15016911 |
Sarasota | 6,000 | 15016914 |
Charlotte | 27,000 | 15016917 |
Effective Dates: 11/01/12 | ||
Glades | 593 | TBD |
Xxxxxx | 6,048 | TBD |
See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 9 Counties: Palm Beach, St. Lucie, Indian River, Okeechobee
Effective Dates: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Palm Beach | 15,000 | 15016910 |
St. Lucie | 4,500 | 15016915 |
Indian River | 10,500 | 15016918 |
Effective Dates: 11/01/12 | ||
Okeechobee | 5,000 | TBD |
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See Exhibit 2-NR Table 2, General Capitation Rates plus Mental Health Rates
Area 10 County: Broward
AHCA Contract No. FA971, Attachment I, Exhibit 1-A, Page 3 of 4
WellCare of Florida, Inc. d/b/a StaywellHealth Plan of Florida | Medicaid Non-Reform HMO Contract | |
Effective Date: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Broward | 25,000 | 15016900 |
See Exhibit 2-NR Table 2, General Capitation Rates, Mental Health Rates
Area 11 County: Miami-Dade
Effective Date: 09/01/12 | ||
County | Enrollment Level | Provider Number |
Miami-Dade | 25,000 | 15016909 |
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AHCA Contract No. FA971, Attachment I, Exhibit 1-A, Page 4 of 4
