--------------------------------------------------------------------------------

Back to Form 8-K [form8k.htm]
 
Exhibit 10.2
 
Medicaid HMO Contract
WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida
 
AHCA CONTRACT NO. FA615
 
AMENDMENT NO. 5
 
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.  
Attachment I, Scope of Services, is hereby amended to include Exhibit II-C,
Third Revised Capitation Rates, attached hereto and made a part of the Contract.
All references in the Contract to Exhibit II-B, Second Revised Capitation Rates,
shall hereinafter also refer to Exhibit II-C, Third Revised Capitation Rates, as
appropriate.
 

2.  
Attachment II, Medicaid Prepaid Health Plan Model Contract, Section V, Covered
Services, Item B, Optional Services, is hereby deleted in its entirety and
replaced with the following:

 
 
B. Optional Services
 
1.The Plan shall offer the following services within all applicable Medicaid
guidelines:
 

 
Covered
Not Covered
Dental Services
 
X
Transportation Services
 
X

 
   3.  Attachment II, Medicaid Prepaid Health Plan Model Contract, Section V,
Covered Services, Item C, Expanded Services, sub-item 2 is hereby deleted in its
entirety and replaced with the following:
 
2.The following is a list of the Health Plan's Expanded Services:
a.  
Annual comprehensive oral exam, x-rays (one (1) per year), two (2) cleanings per
year, silver amalgam fillings, one periodontic deep cleaning per year, two (2)
periodontic scaling and root planing per year.

b.  
Up to $25 credit per household each month for selected over the counter drugs
and/or health supplies.

c.  
Unlimited eye exams and eyeglasses, if medically necessary.

d.  
Circumcision up to one (1) year.

 
4.
This Amendment shall have an effective date of March 1, 2008, or the date on
which both parties execute the Amendment, whichever is later.

 
All provisions in the Contract and any attachments thereto in conflict with this
Amendment shall be and are hereby changed to conform with this Amendment.
 
All provisions not in conflict with this Amendment are still in effect and are
to be performed at the level specified in the Contract.
 
AHCA Contract No. FA615, Amendment No. 5, Page 1 of 2
 
 
 
 

--------------------------------------------------------------------------------

 
 
 
Medicaid HMO Contract
Wellcare of Florida, Inc.  d/b/a Staywell Health Plan of
Florida                                                                                                  
 
 
 
This Amendment and all its attachments are hereby made a part of the Contract.
 
This Amendment cannot be executed unless all previous amendments to this
Contract have been fully executed.
 
IN WITNESS WHEREOF, the parties hereto have caused this two (2) page Amendment
(which includes all attachments hereto) 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/   Heath Schiesser
SIGNED BY:  /s/  Illegible   for
NAME: Heath Schiesser
NAME: Holly Benson
TITLE: President and CEO
TITLE: Secretary
DATE:  3/27/08
Date: 4/2/08

 
List of attachments included as part of this Amendment:
 
Specify Type
Letter/Number
Description
Exhibit
11-C
Third Revised Capitation Rates (1 Page)

 
 
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
 
AHCA Contract No. FA615, Amendment No. 5, Page 2 of 2
 
 

--------------------------------------------------------------------------------

 
 
EXHIBIT II-C
THIRD REVISED CAPITATION RATES
 
 
A.
Table 2 - General Capitation Rates plus Mental Health Rates:

 
Area 3 Counties:
 
County
Provider Number
Hernando
015016901
Sumter
015016916

 
 
Area 5 Counties:
County
Provider Number
Pasco
015016903
Pinellas
015016904

 
 
Area 6 Counties:
County
Provider Number
Hillsborough
015016902
Manatee
015016912
Polk
015016905

 
 
Area 7 Counties:
County
Provider Number
Orange
015016906
Seminole
015016908
Osceola
015016907
Brevard
015016913

 
Area 8 Counties:
County
Provider Number
Lee
015016911
Sarasota
015016914

 
Area 9 Counties:
County
Provider Number
Palm Beach
015016910
St. Lucie
015016915

 
Area 10 Counties:
County
Provider Number
Broward
015016900
   

 
Area 11 Counties:
County
Provider Number
Miami-Date
015016909

 
 
 
AHCA Contract No. FA615, Exhibit 11-C, Page 1 of 1
 
 
 

--------------------------------------------------------------------------------