Coordination of Benefits Agreement Sample Contracts

CENTERS FOR MEDICARE & MEDICAID SERVICES COORDINATION OF BENEFITS AGREEMENT (COBA)
Coordination of Benefits Agreement • October 2nd, 2024

This agreement for coordination of health insurance benefits (hereinafter referred to as “Agreement”) is entered into by and between the "Trading Partner” (as provided in Article IX) and the Centers for Medicare & Medicaid Services (CMS) Contractor (as provided in Article IX).

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CENTERS FOR MEDICARE & MEDICAID SERVICES COORDINATION OF BENEFITS AGREEMENT (COBA) FOR HEALTHCARE PRE-PAYMENT PLANS (HCPPS) AND COST HEALTH MAINTENANCE ORGANIZATIONS (HMOS)
Coordination of Benefits Agreement • July 18th, 2012

This agreement for coordination of health insurance benefits (hereinafter referred to as “Agreement”) is entered into by and between the "Trading Partner” (as provided in Article IX) and the Centers for Medicare & Medicaid Services (CMS) Contractor (as provided in Article IX).

Contract
Coordination of Benefits Agreement • September 13th, 2024

MetroPlus Health Plan, Inc. is an HMO, HMO D-SNP plan with a Medicare contract. MetroPlus Health Plan, Inc. has a contract with New York State Medicaid for MetroPlus UltraCare (HMO D-SNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO D-SNP).

AHCA AGREEMENT NO. AA051
Coordination of Benefits Agreement • October 31st, 2012 • Wellcare Health Plans, Inc. • Hospital & medical service plans

THIS COORDINATION OF BENEFITS AGREEMENT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and WELLCARE OF FLORIDA, INC., hereinafter referred to as the “Health Plan,” is hereby amended as follows:

STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION COORDINATION OF BENEFITS AGREEMENT
Coordination of Benefits Agreement • June 22nd, 2011 • Wellcare Health Plans, Inc. • Hospital & medical service plans

THIS COORDINATION OF BENEFITS AGREEMENT is entered into between the State of Florida, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" whose address is 2727 Mahan Drive, Tallahassee, Florida 32308, and WELLCARE OF FLORIDA, INC. hereinafter referred to as the "Health Plan" whose address is 8735 Henderson Road, Renaissance 2, Tampa, Florida 33634-1143. The Agency and the Health Plan collectively are referred to herein as the "Parties," and each individually as a "Party."

STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION COORDINATION OF BENEFITS AGREEMENT SNP001 AMENDMENT NO. 1
Coordination of Benefits Agreement • November 2nd, 2011 • Wellcare Health Plans, Inc. • Hospital & medical service plans

THIS COORDINATION OF BENEFITS AGREEMENT, entered into between the State of Florida, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and WELLCARE OF FLORIDA, INC. hereinafter referred to as the "Health Plan" is hereby amended as follows:

COORDINATION OF BENEFITS AGREEMENT AGREEMENT NO. AA051 AMENDMENT NO. 2
Coordination of Benefits Agreement • August 3rd, 2012 • Wellcare Health Plans, Inc. • Hospital & medical service plans

THIS COORDINATION OF BENEFITS AGREEMENT, entered into between the State of Florida, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the "Agency" and WELLCARE OF FLORIDA, INC., hereinafter referred to as the “Health Plan,” is hereby amended as follows:

AMENDMENT NO. 1 TO THE COORDINATION OF BENEFITS AGREEMENT BETWEEN WELLCARE OF GEORGIA, INC. AND GEORGIA DEPARTMENT OF COMMUNITY HEALTH
Coordination of Benefits Agreement • October 31st, 2012 • Wellcare Health Plans, Inc. • Hospital & medical service plans • Georgia

THIS AMENDMENT (“Amendment”) is made by and between the Georgia Department of Community Health (“DCH” or “the State”) and WellCare of Georgia, Inc. (Health Plan) and is made effective upon signature of the Commissioner of DCH. Health Plan and DCH collectively are referred to herein as the “Parties”, and each individually as a “Party”.

OREGON HEALTH AUTHORITY COORDINATION OF BENEFITS AGREEMENT
Coordination of Benefits Agreement • December 1st, 2014

THIS COORDINATION OF BENEFITS AGREEMENT is entered into between the Oregon Health Authority, Division of Medical Assistance Programs hereinafter referred to as the "State Medicaid Agency" whose address is 500 Summer Street NE, Salem Oregon 97301, and ., hereinafter referred to as the "Health Plan" whose address is , The State Medicaid Agency and the Health Plan collectively are referred to herein as the "Parties," and each individually as a "Party."

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