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Back to Form 8-K [form_8-k.htm]
 
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
 
DUVAL
 
$
114.37
 
ESCAMBIA
 
$
101.56
 
HIGHLANDS
 
$
112.05
 
JEFFERSON
 
$
98.51
 
LAKE
 
$
74.36
 
MADISON
 
$
98.51
 
MARTIN 
 
$
100.61
 
PUTNAM 
 
$
92.41
 
WAKULLA
 
$
97.01
           
STAYWELL COUNTIES
 
 
 
 
Per Enrollee Per Month:
       
BREVARD 
 
$
90.88
 
BROWARD
 
$
96.87
 
CHARLOTTE 
 
$
98.51
 
COLLIER
 
$
98.51
 
DESOTO 
 
$
98.51
 
HERNANDO
 
$
125.92
 
HILLSBOROUGH
 
$
80.26
 
LEE 
 
$
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

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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/ Todd S. Farha
/s/ Rose Naff
Todd S. Farha
President and CEO
 
Rose M. Naff
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/ Tina Marcario
Notary Public
 
/s/ Amber N. Floyd
Notary Public
4/3/2008
My Commission Expires
 
11/14/2009
My Commission Expires
1. /s/ Eva Mangin
Witness
1. /s/ Amber N. Floyd
Witness
 
Eva Mangin
Print Name
 
Amber N. Floyd
Print Name
2. /s/ Robin Lord
Witness
 
2. /s/ Jennifer Lloyd
Witness
Robin Lord
Print Name
Jennifer Lloyd
Print Name
 
 
/s/ Jennifer Lloyd
Reviewed by: Jennifer Lloyd 12/1/2006
Director of External Affairs
 
 
/s/ Margaret Moody
Reviewed by: Margaret Moody 12/11/2006
Corporate Counsel, FL Bar #460500

 
FHKC Rate Adjustment Amendment 12-06
Page 3 of 3
 

___ FHKC
 TF INSURER