##### 



Exhibit 10.27.2.1   Medicaid HMO Contract
 Amerigroup Florida, Inc.d/b/a Amerigroup Community Care
 
 THIS CONTRACT, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, AMERIGROUP FLORIDA, INC. D/B/A AMERIGROUP COMMUNITY
CARE,
    2.
    
    The following is a list of the Health Plans Expanded Services:
 a.
    
    Adult basic dental benefits, such as cleanings, simple fillings, and/or
extractions.b.
    
    Up to $25 credit per household each month for selected
over-the-counter drugs and/or health supplies.c.
    
    Respite Care services  Annual maximum of not more than
an initial home health visit by an R.N. and eight (8) follow-up visits by an
aide. Follow-up visits are four (4) hours in length. Maximum of sixteen (16)
hours in a given month and thirty-two (32) hours per year.d.
    
    Circumcisions for newborns (routine newborn circumcision
up to twelve (12) weeks of age).
 4.
    
    This Amendment shall have an effective date of September 1, 2007, or the date on which both
parties execute the Amendment, whichever is later.
     AHCA Form 2100-0002 (Rev. NOV03)
AHCA Contract No. FA614, Amendment No. 4, Page 1 of 2




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##### 



Amerigroup Florida, Inc. 
d/b/a Amerigroup Community Care
    
    Medicaid HMO Contract
  AMERIGROUP FLORIDA, INC.
    
    STATE OF FLORIDA, AGENCY FORD/B/A/ AMERIGROUP COMMUNITY CARE
    
    HEALTH CARE ADMINISTRATIONSIGNED BY:
    
    
    
    SIGNED BY:NAME:
    
    William McHugh
    
    NAME:
    
    Andrew C. Agwunobi, M.DTITLE:
    
    CEO
    
    TITLE:
    
    SecretaryDATE:
    
    
    
    DATE:
  Specify
    
    Letter/Type
    
    Number
    
    DescriptionExhibit
    
    II-D
    
    Fourth Revised Capitation
Rates (1 Page)Exhibit
    
    III-A
    
    September 1, 2007- August 31,
2008 Medicaid Non-Reform HMO
Capitation Rates (5 Pages)
 REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
 AHCA
Contract No. FA614, Amendment No. 4, Page 2 of 2
AHCA Form
2100-0002 (Rev. NOV03)




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##### 



Amerigroup Florida, Inc. 
d/b/a Amerigroup Community Care
    
    Medicaid HMO Contract
 EXHIBIT II-D
FOURTH REVISED CAPITATION RATES
  Area 3 Counties:County:
    

    Provider Number:Hernando
    
    
    015005350Lake
    
    
    015005341Area 5 Counties:County:
    

    Provider Number:Pasco
    
    
    015005304Pinellas
    
    
    015005305Area 6 Counties:County:
    

    Provider Number:Hillsborough
    
    
    015005300Polk
    
    
    015005307Manatee
    
    
    015005318Area 7 Counties:County:
    

    Provider Number:Orange
    
    
    015005308Seminole
    
    
    015005313Osceola
    
    
    015005314Brevard
    
    
    015005336Area 8 Counties:County:
    

    Provider Number:Lee
    
    
    015005302Sarasota
    
    
    015005306Area 9 Counties:County:
    

    Provider Number:Palm Beach
    
    
    015005310Area 10 Counties:County:
    

    Provider Number:Broward
    
    
    015005311Area 11 Counties:County:
    

    Provider Number:Miami-Dade
    
    
    015005312
 AHCA
Form 2100-0002 (Rev. NOV03)
AHCA Contract No. FA614, Exhibit II-D, Page 1 of 1




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EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category
 TABLE 1
General Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 TABLE 2
General + Mental Health Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 AHCA Contract No. FA614, Exhibit III-A, Page 1 of 5




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##### 



EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area, Age and Eligibility Category
 TABLE 3
General + MH + Dental Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 TABLE 4
General + MH + Transportation Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 AHCA Contract No. FA614, Exhibit III-A, Page 2 of 5
HMO CapRates_200709-200808 08/10/2007




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##### 



EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area, Age and Eligibility Category
 TABLE 5
General + Transportation Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    
    
    
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 TABLE 6
General + Dental Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    
    
    
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 AHCA Contract No. FA614, Exhibit III-A, Page 3 of 5
HMO CapRates_200709-200808 08/10/2007




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##### 



EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category
 TABLE 7
General + Dental + Transportation Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    
    
    
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 TABLE 8
General + Mental Health + Dental + Transportation Rates:
 TANF
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    SSI-N
    
    
    
    
    
    SSI-B
    
    SSI-ABArea
    
    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
 **** REDACTED****
 AHCA Contract No. FA614, Exhibit III-A, Page 4 of 5
HMO CapRates_200709-200808 08/10/2007




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EXHIBIT III-A
September 1, 2007- August 31, 2008
Medicaid Non-Reform HMO Capitation Rates
By Area , Age and Eligibility Category
 Area
    
    Corresponding CountiesArea 1
    
    Escambia, Okaloosa, Santa Rosa, WaltonArea 2
    
    Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Washington, WakullaArea 3
    
    Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamiliton, Hemando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, UnionArea 4
    
    Baker, Clay, Duval, Flagler, Nassau, St. Johns, VolusiaArea 5
    
    Pasco, PinellasArea 6
    
    Hardee, Highlands, Hillsborough, Manatee, PolkArea 7
    
    Brevard, Orange, Osceola, SeminoleArea 8
    
    Charlotte, Collier, De Soto, Glades, Hendry, Lee, SarasotaArea 9
    
    Indian River, Okeechobee, St. Lucie, Martin, Palm BeachArea 10
    
    BrowardArea 11
    
    Dade, Monroe
  AHCA Contract No. FA614, Exhibit III-A, Page 5 of 5
HMO CapRates_200709-200808 08/10/2007




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

    STATE OF FLORIDA, AGENCY FORD/B/A/ AMERIGROUP COMMUNITY C
    

    HEALTH CARE ADMINISTRATIONSIGNED BY:
    /S/ William McHugh
    
    
      

    SIGNED BY:NAME: William McHugh
    

    NAME: Andrew C. Agwunobi, M.DTITLE:. CEO
    

    TITLE: SecretaryDATE: 8-31-07
    

    DATE:List of attachments included as part of this Amendment:
 Specify
    
    Letter/Type
    
    Number
    
    DescnptionExhibit
    
    II-D
    
    Fourth Revised Capitation Rates (1 Page)Exhibit
    
    III-A
    
    September 1, 2007- August 31, 2008 Medicaid Non-Reform HMO Capitation Rates (5 Pages)
 REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
 AHCA Contract No. FA614, Amendment No. 4, Page 2 of 2
AHCA Form 2100-0002 (Rev. NOV03)