Amerigroup Florida, Inc. Medicaid HMO Contract d/b/a Amerigroup Community Care

AHCA CONTRACT NO. FA614

AMENDMENT NO. 6

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE
ADMINISTRATION, hereinafter referred to as the “Agency” and AMERIGROUP FLORIDA,
INC. D/B/A AMERIGROUP COMMUNITY CARE, hereinafter referred to as the “Vendor” or
“Health Plan”, is hereby amended as follows:

    1. Effective September 1, 2007, Attachment I, Scope of Services, is hereby
amended to include Exhibit III-B, September 1, 2007-August 31, 2008 Medicaid
Non-Reform HMO Capitation Rates, attached hereto and made a part of the
Contract. All references in the Contract to Exhibit III-A, September 1, 2007 —
August 31, 2008 Medicaid Non-Reform HMO Rates, shall hereinafter instead refer
to Exhibit III-B, September 1, 2007- August 31, 2008 Medicaid Non-Reform HMO
Capitation Rates, as appropriate.

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.

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 eight (8) page Amendment
(which includes all attachments hereto) to be executed by their officials
thereunto duly authorized.

          AMERIGROUP FLORIDA, INC.STATE OF FLORIDA, AGENCY FOR D/B/A/ AMERIGROUP
COMMUNITY CAREHEALTH CARE ADMINISTRATION
SIGNED
BY:
      SIGNED
BY: NAME:William McHugh .......................
  NAME:Andrew C. Agwunobi, M.D  
   
TITLE: CEO
      TITLE:Secretary
 
       
DATE:
      DATE: List of attachments included as part of this Amendment:

Specify
Type
  Letter/Number
        .............  
Description
 
       
Exhibit
  III-B   September 1, 2007- August 31, 2008 Medicaid Non-Reform HMO

Capitation Rates (5 Pages)

AHCA Contract No. FA614, Amendment No. 4, Page 1 of 1

1

AHCA Contract No. FA614, Exhibit III-B, Page 1 of 5

EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category
ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

                  TABLE 1                
General Rates:
 
 
 
 

 
  TANF   SSI-N   SSI-B   SSI-AB

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21.54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                             
Female   Male   Female   Male                                        
011,131.99202.30
021,131.99202.30
31,296.42233.58
041,128.87203.75
051,260.50227.66
061,111.64201.87
071,129.81204.44
081,059.95192.36
091,098.82197.96
101,119.46203.01
111,448.96260.41
  105.58
105.58
122.13
106.78
119.09
106.04
107.10
100.83
103.63
106.51
136.24   66.22
66.22
77.48
67.92
75.94
68.10
68.40
64.75
65.91
68.32
86.18   135.19
135.19
156.47
136.68
152.59
135.60
137.11
129.15
132.56
136.20
174.38   72.29
72.29
84.50
74.01
82.61
74.02
74.43
70.40
71.62
74.23
94.02   265.45
265.45
308.68
269.88
301.42
269.07
271.08
255.88
261.85
270.06
343.72   167.89
167.89
196.24
171.79
191.81
171.81
172.77
163.25
166.57
172.18
218.26   347.47
347.47
408.68
358.59
400.30
360.32
361.05
342.35
346.99
360.84
453.77   10,081.87
10,081.87
11,326.29
10,675.98
11,774.49
10,832.05
11,163.75
9,491.26
10,597.24
13,743.01
14,396.52   1,458.88
1,458.88
1,656.79
1,563.58
1,721.01
1,590.31
1,640.70
1,388.78
1,556.56
2,028.53
2,111.55   435.95
435.95
495.12
467.86
514.94
475.95
490.80
415.62
465.60
606.68
631.62   201.26
201.26
233.33
220.87
241.96
225.91
233.68
196.24
221.41
290.75
299.15   222.08
222.08
256.55
242.36
266.53
247.84
256.10
215.38
242.54
319.15
329.01   716.10
716.10
826.59
781.86
857.42
799.09
824.52
694.16
781.98
1,026.77
1,058.44   703.88
703.88
816.63
772.10
846.21
790.01
815.86
685.42
773.10
1,016.73
1,046.51   270.05
270.05
272.84
329.54
228.63
283.50
326.33
190.94
204.68
255.52
335.29   98.2880.72
98.2880.72
91.4075.41
94.1977.67
88.3873.66
85.4570.71
88.9173.77
84.4169.83
91.8076.03
105.0486.99
159.90130.52
TABLE 2
General + Mental Health Rates:
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
          TANF                               SSI-N               SSI-B   SSI-AB

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21.54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                               
                  Female   Male   Female   Male                                
           
01
02
03
04
05
06
07
08
09
10
11
  1,132.01
1,132.02
1,296.43
1,128.88
1,260.51
1,111.66
1,129.83
1,059.96
1,098.84
1,119.48
1,448.98   202.32
202.33
233.59
203.76
227.67
201.89
204.46
192.37
197.98
203.03
260.43   107.22
108.49
123.45
108.15
120.30
107.89
108.88
102.09
105.18
108.43
137.86   77.91
86.47
86.66
77.48
84.61
81.34
81.08
73.55
76.72
81.68
97.47   146.11
148.60
162.55
143.01
160.70
147.98
148.96
134.98
139.72
145.05
181.86   83.21
85.70
90.58
80.34
90.72
86.40
86.28
76.23
78.78
83.08
101.50   269.89
268.86
310.23
271.49
304.71
274.10
275.90
257.36
263.67
272.31
345.62   172.33
171.30
197.79
173.40
195.10
176.84
177.59
164.73
168.39
174.43
220.16   351.22
350.43
410.02
359.98
403.08
364.57
365.12
343.63
348.57
362.79
455.42   10,081.95
10,082.03
11,326.36
10,676.09
11,774.54
10,832.12
11,163.81
9,491.33
10,597.31
13,743.10
14,396.60   1,458.96
1,459.04
1,656.86
1,563.69
1,721.06
1,590.38
1,640.76
1,388.85
1,556.63
2,028.62
2,111.63   443.39
449.74
501.38
477.61
519.96
482.47
496.92
421.62
471.93
615.03
638.59   249.30
280.06
269.08
276.60
274.37
268.01
273.18
230.52
257.55
338.45
338.94   266.06
267.29
277.06
274.33
296.20
286.38
292.26
235.05
263.28
346.52
351.84   797.48
768.77
850.48
819.11
912.32
870.40
891.44
717.07
806.13
1,058.65
1,085.04   734.86
728.75
827.91
789.69
867.11
817.15
841.33
696.24
784.51
1,031.78
1,059.07   271.05
291.04
279.47
354.09
231.36
284.81
328.92
197.79
211.53
262.37
342.52   109.93
113.28
100.38
110.96
101.19
89.33
99.42
97.63
101.39
113.09
167.95   92.37
95.72
84.39
94.44
86.47
74.59
84.28
83.05
85.62
95.04
138.57

2

AHCA Contract No. FA614, Exhibit III-B, Page 2 of 5

EXHIBIT III-A

September 1, 2007- August 31, 2008

Medicaid Non-Reform HMO Capitation Rates

By Area , Age and Eligibility Category

ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

              TABLE 3            
General + MH + Dental Rates:
 
 
 

TANF
  SSI-N   SSI-B   SSI-AB

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21.54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                      Female  
Male   Female   Male                                        
011,132.02202.33109.31
021,132.03202.34110.58
031,296.44233.60126.52
041,128.89203.77110.20
051,260.52227.69123.77
061,111.67201.90110.53
071,129.84204.47111.04
081,059.97192.38105.11
091,098.85197.99108.10
101,119.49203.04111.29
111,448.99260.44141.58
  82.23
90.79
93.00
81.71
91.76
86.79
85.54
79.80
82.75
87.56
105.13   150.59
153.08
169.14
147.39
168.12
153.63
153.58
141.46
145.98
151.15
189.81   86.99
89.48
96.13
84.03
96.98
91.17
90.17
81.69
84.06
88.23
108.20   271.74
270.71
313.24
274.30
311.90
277.72
278.43
260.37
264.42
274.13
347.23   173.97
172.94
200.46
175.89
201.49
180.05
179.84
167.40
169.94
176.05
221.59   354.63
353.84
415.57
365.17
416.36
371.26
369.79
349.19
351.80
366.16
458.40   10,081.95
10,082.03
11,326.37
10,676.09
11,774.55
10,832.13
11,163.81
9,491.34
10,597.31
13,743.11
14,396.61   1,458.97
1,459.05
1,656.88
1,563.70
1,721.08
1,590.40
1,640.77
1,388.87
1,556.64
2,028.64
2,111.65   445.59
451.94
504.76
479.82
524.88
485.64
500.03
424.74
474.66
618.77
642.83   253.12269.40
283.88270.63
274.93282.17
280.43277.68
282.89303.65
273.51291.19
278.58296.97
235.93239.77
262.28267.41
344.93352.19
346.28358.26   800.35
771.64
854.04
822.42
919.87
874.82
894.55
720.67
807.81
1,060.76
1,088.67   738.28
732.17
832.15
793.64
876.10
822.42
845.04
700.54
786.52
1,034.30
1,063.40   271.55
291.54
280.01
356.10
235.79
286.65
330.54
199.27
212.26
264.42
346.92   112.24
115.59
103.46
114.04
109.53
94.11
102.58
100.78
103.23
115.66
172.01   93.85
97.20
86.37
96.42
91.82
77.66
86.31
85.06
86.80
96.69
141.17
TABLE 4
General + MH + Transportation Rates:
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
      TANF                               SSI-N               SSI-B   SSI-AB

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                               
                  Female   Male   Female   Male                                
           
01
02
03
04
05
06
07
08
09
10
11
  1,137.56
1,137.57
1,303.13
1,133.91
1,264.71
1,115.71
1.133.77
1,065.54
1,104.22
1,123.27
1,452.24   203.71
203.72
235.26
205.01
228.72
202.90
205.44
193.77
199.32
203.97
261.24   108.08
109.35
124.49
108.93
120.95
108.52
109.49
102.95
106.02
109.01
138.36   78.43
86.99
87.29
77.95
85.01
81.72
81.45
74.07
77.23
82.04
97.78   148.03
150.52
164.87
144.75
162.15
149.38
150.32
136.91
141.58
146.35
182.98   84.47
86.96
92.09
81.48
91.67
87.31
87.17
77.49
79.99
83.94
102.24   272.98
271.95
313.95
274.28
307.04
276.35
278.09
260.46
266.66
274.42
347.43   174.71
173.68
200.67
175.56
196.90
178.58
179.28
167.12
170.70
176.05
221.56   354.40
353.61
413.86
362.87
405.49
366.89
367.38
346.83
351.65
364.96
457.29   10,125.36
10,125.44
11,381.17
10,720.46
11,809.84
10,866.95
11,201.13
9,532.67
10,640.50
13,782.23
14,425.98   1,486.99
1,487.07
1,692.25
1,592.34
1,743.85
1,612.87
1,664.85
1,415.54
1,584.51
2,053.89
2,130.60   449.03
455.38
508.50
483.38
524.54
487.00
501.77
427.00
477.55
620.11
642.40   251.78
282.54
272.20
279.13
276.38
270.00
275.30
232.88
260.02
340.69
340.62   272.18
273.41
284.79
280.59
301.18
291.30
297.53
240.88
269.38
352.05
355.99   817.47
788.76
875.73
839.55
928.58
886.44
908.63
736.11
826.01
1,076.67
1,098.57   751.37
745.26
848.76
806.56
880.53
830.40
855.51
711.96
800.93
1,046.66
1,070.25   277.82
297.81
288.09
361.06
237.24
290.13
334.56
203.87
218.45
269.67
347.44   123.66
127.01
120.22
126.74
115.22
100.93
111.55
112.43
117.20
130.75
180.46   101.13
104.48
97.05
104.50
95.42
81.99
92.03
92.50
95.70
106.30
146.55

3

AHCA Contract No. FA614, Exhibit III-B, Page 3 of 5

EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category
ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

              TABLE 5            
General + Transportation Rates:
 
 
 

TANF
  SSI-N   SSI-B   SSI-AB

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21.54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                               
  Female   Male   Female   Male                                            
011,137.54203.69
021,137.54203.69
031,303.12235.25
041,133.90205.00
051,264.70228.71
061,115.69202.88
071,133.75205.42
081,065.53193.76
091,104.20199.30
101,123.25203.95
111,452.22261.22
  106.44
106.44
123.17
107.56
119.74
106.67
107.71
101.69
104.47
107.09
136.74   66.74
66.74
78.11
68.39
76.34
68.48
68.77
65.27
66.42
68.68
86.49   137.11
137.11
158.79
138.42
154.04
137.00
138.47
131.08
134.42
137.50
175.50   73.55
73.55
86.01
75.15
83.56
74.93
75.32
71.66
72.83
75.09
94.76   268.54
268.54
312.40
272.67
303.75
271.32
273.27
258.98
264.84
272.17
345.53   170.27
170.27
199.12
173.95
193.61
173.55
174.46
165.64
168.88
173.80
219.66   350.65
350.65
412.52
361.48
402.71
362.64
363.31
345.55
350.07
363.01
455.64   10,125.28
10,125.28
11,381.10
10,720.35
11,809.79
10,866.88
11,201.07
9,532.60
10,640.43
13,782.14
14,425.90   1,486.91
1,486.91
1,692.18
1,592.23
1,743.80
1,612.80
1,664.79
1,415.47
1,584.44
2,053.80
2,130.52   441.59
441.59
502.24
473.63
519.52
480.48
495.65
421.00
471.22
611.76
635.43   203.74
203.74
236.45
223.40
243.97
227.90
235.80
198.60
223.88
292.99
300.83   228.20
228.20
264.28
248.62
271.51
252.76
261.37
221.21
248.64
324.68
333.16   736.09
736.09
851.84
802.30
873.68
815.13
841.71
713.20
801.86
1,044.79
1,071.97   720.39
720.39
837.48
788.97
859.63
803.26
830.04
701.14
789.52
1,031.61
1,057.69   277.61
277.61
281.24
336.51
234.51
288.82
331.97
197.02
211.60
262.82
340.21   112.01
112.01
111.24
109.97
102.41
97.05
101.04
99.21
107.61
122.70
172.41   89.48
89.48
88.07
87.73
82.61
78.11
81.52
79.28
86.11
98.25
138.50
TABLE 6
General + Dental Rates:
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TANF
                                  SSI-N                       SSI-B   SSI-AB  

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                               
                  Female   Male   Female   Male                                
           
01
02
03
04
05
06
07
08
09
10
11
  1,132.00
1,132.00
1,296.43
1,128.88
1,260.51
1,111.65
1,129.82
1,059.96
1,098.83
1,119.47
1,448.97   202.31
202.31
233.59
203.76
227.68
201.88
204.45
192.37
197.97
203.02
260.42   107.67
107.67
125.20
108.83
122.56
108.68
109.26
103.85
106.55
109.37
139.96   70.54
70.54
83.82
72.15
83.09
73.55
72.86
71.00
71.94
74.20
93.84   139.67
139.67
163.06
141.06
160.01
141.25
141.73
135.63
138.82
142.30
182.33   76.07
76.07
90.05
77.70
88.87
78.79
78.32
75.86
76.90
79.38
100.72   267.30
267.30
311.69
272.69
308.61
272.69
273.61
258.89
263.60
271.88
345.33   169.53
169.53
198.91
174.28
198.20
175.02
175.02
165.92
168.12
173.80
219.69   350.88
350.88
414.23
363.78
413.58
367.01
365.72
347.91
350.22
364.21
456.75   10,081.87
10,081.87
11,326.30
10,675.98
11,774.50
10,832.06
11,163.75
9,491.27
10,597.24
13,743.02
14,396.53   1,458.89
1,458.89
1,656.81
1,563.59
1,721.03
1,590.33
1,640.71
1,388.80
1,556.57
2,028.55
2,111.57   438.15
438.15
498.50
470.07
519.86
479.12
493.91
418.74
468.33
610.42
635.86   205.08
205.08
239.18
224.70
250.48
231.41
239.08
201.65
226.14
297.23
306.49   225.42
225.42
261.66
245.71
273.98
252.65
260.81
220.10
246.67
324.82
335.43   718.97
718.97
830.15
785.17
864.97
803.51
827.63
697.76
783.66
1,028.88
1,062.07   707.30
707.30
820.87
776.05
855.20
795.28
819.57
689.72
775.11
1,019.25
1,050.84   271.34
271.34
273.16
331.51
233.06
285.34
327.95
192.42
205.41
257.57
339.69   100.59
100.59
94.48
97.27
96.72
90.23
92.07
87.56
93.64
107.61
163.96   82.20
82.20
77.39
79.65
79.01
73.78
75.80
71.84
77.21
88.64
133.12

4

AHCA Contract No. FA614, Exhibit III-B, Page 4 of 5

EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category
ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

              TABLE 7            
General + Dental + Transportation Rates:
 
 
 

TANF
  SSI-N   SSI-B   SSI-AB

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21.54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                          Female   Male   Female
  Male                                            
011,137.55203.70108.5371.06141.59
021,137.55203.70108.5371.06141.59
031,303.13235.26126.2484.45165.38
041,133.91205.01109.6172.62142.80
051,264.71228.73123.2183.49161.46
061,115.70202.89109.3173.93142.65
071,133.76205.43109.8773.23143.09
081,065.54193.77104.7171.52137.56
091,104.21199.31107.3972.45140.68
101,123.26203.96109.9574.56143.60
111,452.23261.23140.4694.15183.45
  77.33
77.33
91.56
78.84
89.82
79.70
79.21
77.12
78.11
80.24
101.46   270.39
270.39
315.41
275.48
310.94
274.94
275.80
261.99
266.59
273.99
347.14   171.91
171.91
201.79
176.44
200.00
176.76
176.71
168.31
170.43
175.42
221.09   354.06
354.06
418.07
366.67
415.99
369.33
367.98
351.11
353.30
366.38
458.62   10,125..28
10,125.28
11,381.10
10,720.35
11,809.79
10,866.88
11,201.07
9,532.60
10,640.43
13,782.14
14,425.90   1,486.92
1,486.92
1,692.20
1,592.24
1,743.82
1,612.82
1,664.80
1,415.49
1,584.45
2,053.82
2,130.54   443.79
443.79
505.6
475.84
524.44
483.65
498.76
424.12
473.95
615.50
639.67   203.74
203.74
242.30
227.23
252.49
233.40
241.20
204.01
228.61
299.47
308.17   228.20
228.20
269.39
251.97
278.96
257.57
266.08
225.93
252.77
330.35
339.58   736.09
736.09
855.40
805.61
881.23
819.55
844.82
716.80
803.54
1,046.90
1,075.60   723.81
723.81
841.72
792.92
868.62
808.53
833.75
705.44
791.53
1,034.13
1,062.02   278.11
278.11
281.78
338.52
238.94
290.66
333.59
198.50
212.33
264.87
344.61   114.32
114.32
114.32
113.05
110.75
101.83
104.20
102.36
109.45
125.27
176.47   90.96
90.96
90.05
89.71
87.96
81.18
83.55
81.29
87.29
99.90
141.10
TABLE 8
General + Mental Health + Dental + Transportation Rates:
 

 

 

 

 

 

 

 

 

 

 

 

 

 

TANF
                      SSI-N                       SSI-B   SSI-AB  

Area BTHM0+2M0 3M0.11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+)
BTHMO+2M0 3M0-11MO AGE (1-5) AGE (6-13) AGE (14-20) AGE (21-54) AGE (55+) AGE
(65-) AGE (65+)

                                                                               
                  Female   Male   Female   Male                                
           
01
02
03
04
05
06
07
08
09
10
11
  1,137.57
1,137.58
1,303.14
1,133.92
1,264.72
1,115.72
1,133.78
1,065.55
1,104.23
1,123.28
1,452.25   203.72
203.73
235.27
205.02
228.74
202.91
205.45
193.78
199.33
203.98
261.25   110.17
111.44
127.56
110.98
124.42
111.16
111.65
105.97
108.94
111.87
142.08   82.75
91.31
93.63
82.18
92.16
87.17
85.91
80.32
83.26
87.92
105.44   152.51
155.00
171.46
149.13
169.57
155.03
154.94
143.39
147.84
152.45
190.93   88.25
90.74
97.64
85.17
97.93
92.08
91.06
82.95
85.27
89.09
108.94   274.83
273.80
316.96
277.09
314.23
279.97
280.62
263.47
268.41
276.24
349.04   176.35
175.32
203.34
178.05
203.29
181.79
181.53
169.79
172.25
177.67
222.99   357.81
357.02
419.41
368.06
418.77
373.58
372.05
352.39
354.88
368.33
460.27   10,125.36
10,125.44
11,381.18
10,720.46
11,809.85
10,866.96
11,201.13
9,532.68
10,640.50
13,782.24
14,425.99   1,487.00
1,487.08
1,692.27
1,592.35
1,743.87
1,612.89
1,664.86
1,415.56
1,584.52
2,053.91
2,130.62   451.23
457.58
511.88
485.59
529.46
490.17
504.88
430.12
480.28
623.85
646.64   255.60
286.36
278.05
282.96
284.90
275.50
280.70
238.29
264.75
347.17
347.96   275.52
276.75
289.90
283.94
308.63
296.11
302.24
245.60
273.51
357.72
362.41   820.34
791.63
879.29
842.86
936.13
890.86
911.74
739.71
827.69
1,078.78
1,102.20   754.79
748.68
853.00
810.51
889.52
835.67
859.22
716.26
802.94
1,049.18
1,074.58   278.32
298.31
288.63
363.07
241.67
291.97
336.18
205.35
219.18
271.72
351.84   125.97
129.32
123.30
129.82
123.56
105.71
114.71
115.58
119.04
133.32
184.52   102.61
105.96
99.03
106.48
100.77
85.06
94.06
94.51
96.88
107.95
149.15

5

EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category

     
Area
Area 1
Area 2
Area 3
Area 4
Area 5
Area 6
Area 7
Area 8
Area 9
Area 10
Area 11
  ESTIMATED HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)
Corresponding Counties
Escambia, Okaloosa, Santa Rosa, Walton
Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon,
Liberty, Madison, Taylor, Washington, Wakulla
Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamiliton, Hemando,
Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, Union
Baker, Clay, Duval, Flagler, Nassau, St. Johns, Volusia
Pasco, Pinellas
Hardee, Highlands, Hillsborough, Manatee, Polk
Brevard, Orange, Osceola, Seminole
Charlotte, Collier, De Soto, Glades, Hendry, Lee, Sarasota
Indian River, Okeechobee, St. Lucie, Martin, Palm Beach
Broward
Dade, Monroe

Created on August 10, 2007
AHCA Contract No. FA614, Exhibit III-B, Page 5 of 5

6