2008-000024A FIRST AMENDMENT PHYSICAL HEALTH INSURANCE CONTRACT AGREEMENT BETWEEN
Exhibit 10.1
AGREEMENT BETWEEN
Puerto Rico Health Insurance Administration (PRHIA) a public instrumentality of the Commonwealth of
Puerto Rico organized pursuant to Act 72, of September 7, 1993, as amended, hereinafter referred to
as the “ADMINISTRATION”, and represented by it’s Executive Director, Xx. Xxxxxxx Xxxxxx Xxxxxxxx;
And
TRIPLE S, INC., a private corporation duly organized and authorized to do business under the laws
of the Commonwealth of Puerto Rico, with Employer Social Security Number ###-##-####, hereinafter
referred to as “INSURER”, and represented by its Chief Executive Director, Xx. Xxxxxxx Xxxxx;
Contractor Name
For the Provision fo Health Insurance coverage to eligible population under the Government
Health Insurance Plan
WITNESSETH
In consideration of the mutual covenants and agreements hereinafter set forth, the parties, their
respective representatives and successors, agree as follows:
FIRST: The ADMINISTRATION has the responsibility to negotiate contracts with Managed Care
Organizations (INSURER) or Insurance Companies to provide health insurance coverage to eligible
population as certified by Medicaid Program (MAP) under the Government Health Insurance Plan (GHIP)
administered by the PRHIA and other beneficiaries that meet the requirements Law 72 of September 7,
1993 as amendment.
SECOND: On July 13, 2007 the ADMINISTRATION and Triple-S, Inc. entered into Contract Number 08-024,
for the provision of Health Insurance Coverage to eligible population in the North and Southwest
Region.
THIRD: The contract also established in Appendix C the Premium Rates for the period of November 1,
2006 to June 30, 2007, which also are the Interim Premium Rates for the fiscal year beginning July
1, 2007 to June 30, 2008.
Now, therefore the parties agree to amend Appendix C, to incorporate the Final Premium Rate for the
current fiscal year period.
HENCEFORTH: The Appendix C is amended and made part of this Contract as if set forth fully herein.
Al other term and conditions of the contract remains unchanged. In witness whereof, the parties
have duly execute this amendment on the this _20___day of September, 2007 and affixes below
their respective signature.
/s/ Xxxxxxx Xxxxxx Xxxxxxxx
|
September 20, 2007 | |
XXXXXXX XXXXXX XXXXXXXX, ESQ.
|
Date of Signature | |
Executive Director
|
(month/day/year) | |
Puerto Rico Health Insurance Administration |
||
/s/ Xxxxxxx Xxxxx
|
September 20, 2007 | |
XXXXXXX XXXXX
|
Date of Signature | |
President & CEO
|
(month/day/year) | |
Triple S, Inc. |
||
/s/ Xxxx X. Xxxxxx
|
September 20, 2007 | |
XXXX X. XXXXXX, DMD
|
Date of Signature | |
President & CEO
|
(month/day/year) | |
Triple-C, Inc. |
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Appendix C
TRIPLE S / TRIPLE C, INC.
HEALTH OPTIONS MANAGEMENT
HEALTH OPTIONS MANAGEMENT
The monthly premiums for all beneficiaries, including all those who are sixty-five (65) years and
older who are Medicare beneficiaries Part A or Part A and B those who are sixty-five years and
older who are not Medicare recipients is establish below on a per member per month (pmpm) rate; for
the period of November 1st, 2006 to June 30, 2007.
Monthly Premiums Rates
| Region or Area | Premiums Rates | |||
South West |
$ | 72.00 | ||
North |
$ | 73.76 | ||
The monthly premiums for all beneficiaries, including all those who are sixty-five (65) years and
older who are Medicare beneficiaries Part A or Part A and B those who are sixty-five years and
older who are not Medicare recipients is establish below on a per member per month (pmpm) rate; for
the period of July 1st, 2007 to June 30, 2008.
Monthly Premiums Rates
| Region or Area | Premiums Rates | |||
South West |
$ | 78.27 | ||
North |
$ | 80.06 | ||
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