Exhibit 10.5
 AMENDMENT #4 TO CONTRACT NO. 0652 BETWEEN
GEORGIA DEPARTMENT OF COMMUNITY HEALTH AND
AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.
 26th August #
  Amendments in Writing,
 NOW THEREFORE,
 I.
    
    To delete the current Section 26.0 PAYMENT BOND & IRREVOCABLE LETTER
OF CREDITin its entirety and replace with the following:
 26.0 PAYMENT BOND& IRREVOCABLE LETTER OF CREDIT
 Section 26.1
    
    Within five (5) Business Days of Contract Execution, Contractor
shall obtain and maintain in force and effect an irrevocable letter of
credit in the amount representing one half of one months total Net
Capitation Payment associated with the actual GCS lives enrolled in
Contractors plan. On or before July 2 each following year, Contractor
shall modify the amount of the irrevocable letter of credit currently
in force and effect to equal one-half of the average of the Net
Capitation Payments paid to the Contractor for the months of January,
February and March. If at any time during the year, the actual GCS
lives enrolled in Contractors plan increases or decreases by more
than twenty-five percent, DCH, at it sole discretion, may increase or
decrease the amount required for the irrevocable letter of credit.
Notwithstanding the above, in the event that the amount of the
irrevocable letter of credit required hereunder would exceed
 Page 1 of 4




---



##### 



With regard to the irrevocable letter of credit, DCH may recoup payments from the Contractor
for liabilities or obligations arising from any act, event, omission or condition which occurred
or existed subsequent to the effective date of the Contract and which is identified in a survey,
review, or audit conducted or assigned by DCH.
 Section 26.2
    
    DCH may also, at its discretion, redeem Contractors irrevocable
letter of credit in the amount(s) of actual damages suffered by DCH if DCH
determines that the Contractor is (1) unable to perform any of the terms and
conditions of the Contract or if (2) the Contractor is terminated by default or
bankruptcy or material breach that is not cured within the time specified by
DCH, or under both conditions described at one (1) and two (2).
 Section 26.3
    
    During the Contract period, Contractor shall obtain
and maintain a payment bond from an entity licensed
to do business in the State of Georgia and acceptable
to DCH with sufficient financial strength and
creditworthiness to assume the payment obligations of
Contractor in the event of a default in payment
arising from bankruptcy, insolvency, or other cause.
Said bond shall be delivered to DCH within five (5)
Business Days of Contract Execution and shall be in
the amount of Five Million Dollars ($5,000,000.00).
On or before July 2, of each following year,
Contractor shall modify the amount of the bond to
equal the average of the Net Capitation Payments paid
to the Contractor for the months of January, February
and March.
If at any time during the year, the actual GCS lives enrolled in
Contractors plan increases or decreases by more than twenty-five percent,
DCH, at its sole discretion, may increase or decrease the amount required
for the bond.
 II.
    
    DCH and Contractor agree that they have assumed an obligation to perform the covenants,
agreements, duties and obligations of the Contract, as modified and amended herein, and agree
to abide by all the provisions, terms and conditions contained in the Contract as modified and
amended.
 Page 2 of 4




---



##### 



III.
    
    This Amendment shall be binding and inure to the benefit of the parties hereto, their
heirs, representatives, successors and assigns. Whenever the provisions of this Amendment and
the Contract are in conflict, the provisions of this Amendment shall take precedence and
control.VI.
    
    It is understood by the Parties hereto that, if any part, term, or provision of this Amendment or this entire Amendment
is held to be illegal or in conflict with any law of this State, then DCH, at its sole option, may enforce the remaining
unaffected portions or provisions of this Amendment or of the Contract and the rights and obligations of the parties
shall be construed and enforced as if the Contract or Amendment did not contain the particular part, term or provision
held to be invalid.VII.
    
    This Amendment shall become effective as stated herein and shall remain effective for so long as the Contract is in
effect.
VIII. This Amendment shall be construed in accordance with the laws of the State of Georgia.IX.
    
    All other terms and conditions contained in the Contract and any amendment thereto, not amended by this Amendment, shall
remain in full force and effect.
 - SIGNATURES ON THE FOLLOWING PAGE -
 Page 3 of 4




---



##### 



GEORGIA DEPARTMENT OF COMMUNITY HEALTH
 /s/ Dr. Rhonda M. MedowsDr. Rhonda M. Medows, M.D.
    
    Date
8/26/08Commissioner
 AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.
 BY:
    
    /s/ Melvin Lindsey
    
    Date 5/29/08*SIGNATUREPlease Print/Type Name Here)AFFIX CORPORATE SEAL HERE 
(Corporations
without a seal, attach
a Certificate of 
Corporate Resolution)ATTEST:
    
    /s/ Stanley F. Baldwin**SIGNATURECorporate SecretaryTITLE
 
 *
    
    Must be President, Vice President, CEO or Other Authorized Officer**
    
    Must be Corporate Secretary Page 4 of 4