fa905amendment6.htm


Back to Form 10-Q


Exhibit 10.16




 



	
HealthEase of Florida, Inc.

	  	
Medicaid HMO Non-Reform Contract


	
 

	  	  





 


AHCA CONTRACT NO. FA905


AMENDMENT NO. 6







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








	
1.

	
Effective August 1, 2011, Attachment I, Scope of Services, Capitated Health Plans, is hereby amended to include Attachment I, Exhibit 1-A, Revised Maximum Enrollment Levels, attached hereto and made a part of the Contract.  All references in the Contract to Attachment I, Exhibit 1, shall hereinafter also refer to Attachment I, Exhibit 1-A, as appropriate.


 


	
2.

	
Attachment II, Core Contract Provisions, Section XVI., Terms and Conditions, is hereby amended to include Item GG. as follows:


 


	  	
GG.  Work Authorization Program


 


	  	
The immigration Reform and Control Act of 1986 prohibits employers from knowingly hiring illegal workers.  The Vendor shall only employ individuals who may legally work in the United States – either U.S. citizens or foreign citizens who are authorized to work in the U.S.  The Vendor shall use the U.S. Department of Homeland Security’s E-Verify Employment Eligibility Verification system to verify the employment eligibility of:













	  	
Ø 

	
all persons employed by the Vendor, during the term of this Contract, to perform employment duties within Florida; and,


 


	  	
Ø 

	
all persons (including subcontractors) assigned by the Vendor to perform work pursuant to this Contract.













	  	
The Vendor shall include this provision in all subcontracts it enters into for the performance of work under this Contract.


	  	  
	  	
Unless otherwise stated, this amendment is effective upon execution by both parties.


	  	  
	  	
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.







 


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AHCA Contract No. FA905, Amendment No. 6, Page 1 of 2






  





  











  














	

HealthEase of Florida, Inc.



	  	
Medicaid HMO Non-Reform Contract


	
 

	  	  










IN WITNESS WHEREOF, the Parties hereto have caused this six (6) page amendment (including all attachments) to be executed by their officials thereunto duly authorized.








	
HEALTHEASE OF FLORIDA, INC.

	
STATE OF FLORIDA, AGENCY FOR 


HEALTH CARE ADMINISTRATION


	  	  	  	  	  	  
	
SIGNED

	  	  	
SIGNED

	  	  
	
BY:

	
/s/Christina Cooper

	  	
BY:

	  /s/ Elizabeth Dudek





 



	
NAME:

	
Christina Cooper

	  	
Name:

	
Elizabeth Dudek


	
 


TITLE:

	
 


President, Florida & Hawaii Division

	  	
 


TITLE:

	
 


Secretary


	
 


DATE:

	
 


6/29/11

	  	
 


DATE:

	6/30/2011





 


 


List of Attachments/Exhibits included as part of this amendment:


 



	
Specify


Type

	  	
Letter/


Number

	  	
 


Description


	
Attachment I

	  	
Exhibit 1-A

	  	
Revised Maximum Enrollment Levels (4 Pages)

















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AHCA Contract No. FA905, Amendment No. 6, Page 2 of 2











  





  











  






 



	

HealthEase of Florida, Inc.



	  	
Medicaid HMO Non-Reform Contract


	
 

	  	  










ATTACHMENT I


EXHIBIT 1-A


REVISED MAXIMUM ENROLLMENT LEVELS







Maximum enrollment levels and Health Plan provider numbers associated with the counties and populations served.  Exhibit 2-NR-B provide the capitation rate tables respective to the areas of operation listed below.







A.  Non-Reform







See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 1 Counties: Santa Rosa


 


	  	
Effective Date: 08/01/11


	  	
County

	
Enrollment Level

	
Provider Number


	  	
Santa Rosa

	
31,500

	
TBD












See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 2 Counties: Calhoun, Gadsden, Jefferson, Leon, Liberty, Madison, Wakulla


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	  	
Calhoun

	
800

	
015019340


	  	
Gadsden

	
3,500

	
015019315


	 	Jefferson	 1,000	 015019318
	 	Leon	 7,000	 015019320
	 	Liberty	 400	 015019342
	 	Madison	 1,500	 015019322
	 	Wakulla	 1,000	 015019336





 


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AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 1 of 4


 




  





  











  












	

HealthEase of Florida, Inc.



	  	
Medicaid HMO Non-Reform Contract


	
 

	  	  










See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 3 Counties: Citrus, Lake, Marion, Putnam


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	  	
Citrus

	
7,500

	
015019309


	  	
Lake

	
7,000

	

015019319




	  	
Marion

	
20,000

	

015019323




	  	
Putnam

	
6,000

	

015019329














See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 4 Counties: Duval, Volusia


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	  	
Duval

	
55,000

	
015019313


	  	
Volusia

	
15,000

	
015019335












See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 5 Counties: Pasco, Pinellas


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	  	Pasco	6,000	015019302
	  	
Pinellas

	
9,000

	015019303





 


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AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 2 of 4


 






  





  











  












	

HealthEase of Florida, Inc.



	  	
Medicaid HMO Non-Reform Contract


	
 

	  	  










 


See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 6 Counties:  Highlands, Hillsborough, Manatee, Polk


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	 	Highlands	 3,000	 015019317
	 	Hillsborough	 18,000	 015019300
	 	Manatee	 6,000	 015019301
	  	
Polk

	10,000	015019304





 


 



See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 7 Counties: Brevard, Orange, Osceola, Seminole


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	 	Brevard	14,000	015019308
	 	Orange	25,000	015019327
	 	Osceola	8,000	015019328
	  	
Seminole

	4,000	015019333





 




 


See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 8 Counties: Sarasota


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	  	
Sarasota

	
3,000

	
015019332






















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AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 3 of 4


 


 









  





  











  
















	

HealthEase of Florida, Inc.



	  	
Medicaid HMO Non-Reform Contract


	
 

	  	  










 


See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 9 Counties: Martin, Palm Beach


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	 	 Martin	5,000 	 015019324
	 	 Palm Beach	 10,500	 015019339





 


 



See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 10 Counties: Broward


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	 	 Broward	 13,500	015019337 





 




 


See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates








	  	
Area 11 Counties: Miami-Dade


 


	  	
Effective Date: 09/01/09


	  	
County

	
Enrollment Level

	
Provider Number


	  	
 Miami-Dade

	
25,000

	
015019338






















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AHCA Contract No. FA905, Attachment I, Exhibit 1-A, Page 4 of 4