exhibit10-4.htm


    
      

    

    Back
      to Form 8-K

    Exhibit
      10.4

     

    Medicaid
      Reform HMO Contract

     

    
      Wellcare
        of Florida, Inc. d/b/a Staywell
        

    

     

    
      


      AHCA
        CONTRACT NO. FAR009

      AMENDMENT
        NO. 6

      


      


      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, hereinafter referred to as the “Vendor,” is hereby amended as
        follows:

       

      
        	
                 

              	
                1.

              	
                Effective
                  September 1, 2007, Attachment I, Scope of Services, is hereby amended
                  to
                  include Exhibit 5-B, attached hereto and made a part of the Contract.
                  All
                  references in the Contract to Exhibit 5-A, shall hereinafter instead
                  refer
                  to Exhibit 5-B. 

              


      

      


      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, is hereby made 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 (including all attachments) to be
        executed by their officials thereunto duly authorized.

      


      


      
        	
                WELLCARE
                  OF FLORIDA, INC. 

                D/B/A
                  STAYWELL 

              	
                STATE
                  OF FLORIDA, AGENCY FOR 

                HEALTH
                  CARE ADMINISTRATION

              
	
                SIGNED
                  BY:   /s/  Todd
                  S. Farha

              	
                SIGNED
                  BY:   /s/  Andrew
                  C. Agwunobi

              
	
                NAME: Todd
                  S.
                  Farha

              	
                NAME: 
                  Andrew
                  C.
                  Agwunobi, M.D.

              
	
                TITLE:  President
                  and
                  CEO

              	
                TITLE: 
                  Secretary

              
	
                DATE: 
                  12/7/07                                
                  

              	
                DATE: 
                  12/10/07                      
                  

              
	 	 
	 	 
	
                List
                  of attachments included as part of this Amendment:

              
	
                Specify
                  Type

              	
                Letter/
                  Number                                
                  

              	
                Description

              
	
                Exhibit

              	
                5-B

              	
                Capitation
                  Rates SSI Medicare Part B Only and SSI Medicare Parts A and B Enrollees
                  for All Medicaid Reform Counties (1
                  Page)

              


      

      


      


      REMAINDER
        OF THIS PAGE INTENTIONALLY LEFT BLANK 

       

       

      
        
          
            AHCA
              Contract No. FAR009, Amendment No. 6, Page 1 of 1

          

          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

       

      EXHIBIT
        5 - B

      CAPITATION
        RATES

      SSI
        MEDICARE PART B ONLY

      AND

      SSI
        MEDICARE PARTS A AND B ENROLLEES

      FOR
        ALL MEDICAID REFORM COUNTIES


      


      


      
        	
                 

              	
                TABLE
                  4 

              


      

      


      


      
        	
                Area: 4 

              	
                County:

              	
                Duval,
                  Baker, Clay and
                  Nassau

              


      

      


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


      
      

      
        	 	
                Under
                  Age 65

              	
                Age
                  65 & Over

              
	
                SSI/Parts
                  A & B

              	
                $159.09

              	
                $107.50

              
	
                SSI/Part
                  B Only

              	
                $368.77

              	
                $368.77

              


      

       

       

      
        	
                Area: 10

              	
                County:

              	
                Broward  
                  

              


      

       

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

         

      

      
      

      
        	 	
                Under
                  Age 65

              	
                Age
                  65 & Over

              
	
                SSI/Parts
                  A & B

              	
                $151.52

              	
                $102.61

              
	
                SSI/Part
                  B Only

              	
                $248.51

              	
                $248.51

              


      

      


      


      REMAINDER
        OF PAGE INTENTIONALLY LEFT BLANK

       

       

      AHCA
        Contract No. FAR009, Exhibit 5-B, Page 1 of
        1