EX-10.3






Exhibit 10.3




Contract with Approved Entity Pursuant to Sections 1860D-1 through 1860D-42 of

the Social Security Act for the Operation of a Voluntary Medicare Prescription

Drug Plan




Between




Centers for Medicare & Medicaid Services (hereinafter referred to as “CMS”)




And




WellCare Prescription Insurance, Inc. (S5967)

(a Prescription Drug Plan Sponsor, hereinafter referred to as the “PDP Sponsor”)




CMS and the PDP Sponsor, an entity that has been determined eligible to operate a Voluntary
Medicare Prescription Drug Plan by the Administrator of CMS under


423 CFR §423.503, agree to the following for the purposes of sections 1860D-1 through 1860D-42.
(with the exception of sections 1860D-22(a) and 1860D-31) of the Social Security Act (hereinafter
referred to as “the Act.”)



Article I

Medicare Voluntary Prescription Drug Benefit





	 	A.	 	PDP Sponsor agrees to operate one or more Medicare Voluntary Prescription Drug Plans
(hereinafter referred to as a “PDP”), as described in its application and related materials,
including but not limited to all the attestations contained therein and all supplemental
guidance, for Medicare approval and in compliance with the provisions of this contract, which
incorporates in its entirety the Solicitation For Applications from Prescription Drug Plans
released on January 21, 2005(as revised on March 9, 2005) (hereinafter collectively referred
to as “the contract”). The PDP Sponsor also agrees to operate in accordance with the
regulations at 42 CFR §423.1 through 42 CFR §423.910 (with the exception of Subparts Q, R, and
S), sections 1860D-1 through 1860D-42 (with the exception of sections 1860D-22(a) and
1860D-31) of the Social Security Act, and the solicitation, as well as all other applicable
Federal statutes, regulations, and policies. This contract is deemed to incorporate any
changes that are required by statute to be implemented during the term of this contract and
any regulations or policies implementing or interpreting such statutory provisions.






	 	B.	 	CMS agrees to perform its obligations to the PDP Sponsor consistent with the regulations at
42 CFR §423.1 through 42 CFR §423.910 (with the exception of Subparts Q, R and S), sections
1860D-1 through 1860D-42 of the Social Security Act (with the exception of sections
1860D-22(a) and 1860D-31) and the solicitation, as well as all other applicable Federal
statutes, regulations, and policies.






	 	C.	 	CMS agrees that it will not implement, other than at the beginning of a calendar year,
regulations under 42 CFR Part 423 that impose new, significant regulatory requirements on the
PDP Sponsor. This provision does not apply to new requirements mandated by statute.






	 	D.	 	This contract is in no way intended to supersede or modify 42 CFR, Part 423. Failure to
reference a regulatory requirement in this contract does not affect the applicability of such
requirements to the PDP Sponsor and CMS.





Article II

Functions to be Performed by the PDP Sponsor




A. ENROLLMENT




	 	1.	 	PDP Sponsor agrees to accept new enrollments, make enrollments effective,






process voluntary disenrollments, and limit involuntary disenrollments, as


described in 42 CFR, Part 423, Subpart B.




	 	2.	 	PDP Sponsor agrees to comply with the prohibition in 42 CFR 423.104(b) on discrimination in
beneficiary enrollment.





2





	 	1.	 	PDP Sponsor agrees to provide the basic prescription drug coverage as defined under
42 CFR §423.100 and, to the extent applicable, supplemental benefits as defined in 42 CFR
§423.100 and in accordance with Subpart C of 42 CFR Part 423. PDP Sponsor also agrees to
provide Part D benefits as described in the PDP Sponsor’s bid(s) approved each year by CMS
(as referenced in Attachment A, to be replaced each year upon renewal of the contract to
reflect the Sponsor’s approved bids for the succeeding contract year).






	 	2.	 	PDP Sponsor agrees to calculate and collect beneficiary premiums in accordance with 42
CFR §§423.286 and 423.293.






	 	C.	 	DISSEMINATION OF PLAN INFORMATION






	 	1.	 	PDP Sponsor agrees to provide the information required in 42 CFR §423.48.






	 	2.	 	PDP Sponsor agrees to disclose information to beneficiaries in the manner and the
form specified by CMS under 42 CFR §§423.128, 423.50 and in the “Marketing Materials
Guidelines for Medicare Advantage-Prescription Drug Plans (MA-PDs) and Prescription Drug
Plans (PDPs),” and to comply with requirements in 42 CFR §423.50 requiring certain
approvals of marketing materials prior to distribution.






	 	3.	 	PDP Sponsor certifies that all materials it submits to CMS under the File and Use
Certification authority described in the Marketing Materials Guidelines are accurate,
truthful, not misleading, and consistent with CMS marketing guidelines.






	 	D.	 	QUALITY ASSURANCE/UTILIZATION MANAGEMENT






PDP Sponsor agrees to operate quality assurance, drug utilization management, and medication
therapy management programs, and to support electronic prescribing in accordance with Subpart D
of 42 CFR Part 423.




	 	E.	 	APPEALS AND GRIEVANCES






PDP Sponsor agrees to comply with all requirements in Subpart M of 42 CFR Part 423 governing
coverage determinations, grievances and appeals, and formulary exceptions.




	 	F.	 	PAYMENT TO PDP SPONSOR






	 	1.	 	PDP Sponsor and CMS agree that payment under this contract will be governed by the
rules in Subpart G of 42 CFR Part 423.





3





	 	2.	 	If the PDP Sponsor is participating in the Part D Reinsurance Payment Demonstration,
described in 70 FR 9360 (Feb. 25, 2005) it affirms that it will not seek payment under the
demonstration for services provided to employer group enrollees.






	 	3.	 	PDP Sponsor agrees that it is bound by all applicable federal laws and regulations,
guidance, and authorities pertaining to claims and debt collections. In the event that the
government determines that the PDP Sponsor has been overpaid, the PDP Sponsor agrees to
return those overpaid monies back to the federal government.






	 	G.	 	BID SUBMISSION AND REVIEW






If the PDP Sponsor intends to participate in the Part D program for the next program year, PDP
Sponsor agrees to submit the next year’s bid, including all required information on premiums,
benefits, and cost-sharing, by the applicable due date, as provided in Subpart F of 42 CFR Part
423 so that CMS and the Part D plan sponsor may conduct negotiations regarding the terms and
conditions of the proposed bid and benefit plan renewal.




	 	H.	 	STATE LAW AND LICENSURE REQUIREMENTS






	 	1.	 	PDP Sponsor agrees to comply with State law to the extent that it is not preempted by
Federal law as described in Subpart I of 42 CFR Part 423.






	 	2.	 	PDP Sponsor agrees that where it is operating in a State using a waiver granted
pursuant to 42 CFR §423.410, such waiver shall be valid for three consecutive program
years. PDP Sponsor agrees that expiration of the licensure waiver (and the failure to
obtain a license from the relevant State) may be the basis for CMS deleting from the PDP
Sponsor’s service area those PDP Regions affected by the waiver expiration. CMS may
terminate or non-renew the PDP Sponsor’s contract where the expiration of the waiver
results in the PDP Sponsor not being qualified to offer a PDP plan in any PDP Region.






	 	3.	 	PDP Sponsor agrees that where it is operating in a State using a waiver granted
pursuant to 42 CFR §423.415, such waiver shall be valid for the period that the Secretary
of the Department of Health and Human Services determines is appropriate for timely
processing of the PDP Sponsor’s license application by the State, but in no case no more
than one year only, beginning on January 1 of the contract year for which CMS granted the
waiver.






	 	I.	 	COORDINATION WITH OTHER PRESCRIPTION DRUG COVERAGE






	 	1.	 	PDP Sponsor agrees to comply with the coordination requirements with State Pharmacy
Assistance Programs (SPAPs) and plans that provide other prescription drug coverage as
described in Subpart J of 42 CFR Part 423.





4





	 	2.	 	PDP Sponsor agrees to comply with Medicare Secondary Payer procedures as stated in 42
CFR §423.462.






	 	J.	 	SERVICE AREA AND PHARMACY ACCESS






	 	1.	 	The PDP Sponsor agrees to provide Part D benefits in the service area for which it has
been approved by CMS utilizing a pharmacy network and formulary approved by CMS that meet
the requirements of 42 CFR §423.120.






	 	2.	 	The PDP Sponsor agrees to provide Part D benefits through out-of-network pharmacies
according to 42 CFR §423.124.






	 	3.	 	PDP Sponsor agrees to provide benefits by means of point of service systems to
adjudicate prescription drug claims in a timely and efficient manner in compliance with CMS
standards, except when necessary to provide access in underserved areas, I/T/U pharmacies
(as defined in 42 CFR §423.100), and long- term care pharmacies (as defined in 42 CFR
§423.100).






	 	4.	 	PDP Sponsor agrees to contract with any pharmacy that meets the PDP Sponsor’s
reasonable and relevant standard terms and conditions.






	 	K.	 	COMPLIANCE PLAN/PROGRAM INTEGRITY






	 	1.	 	PDP Sponsor agrees that it will develop and implement a compliance plan that applies to
its Part D-related operations, consistent with 42 CFR §423.504(b)(4)(vi).






	 	2.	 	The PDP sponsor agrees to provide notice based on best knowledge, information, and
belief to CMS of any integrity items related to payments from governmental entities, both
federal and state, for healthcare or prescription drug services that would have been
reported as part of 3.1.4 of the PDP application. These items include any investigations,
legal actions or matters subject to arbitration brought involving the sponsor (or sponsor’s
firm if applicable) and its subcontractors (excluding contracted network providers),
including any key management or executive staff, or any major shareholders (5% or more), by
a government agency (state or federal) on matters relating to payments from governmental
entities, both federal and state, for healthcare and/or prescription drug services. In
providing the notice, the sponsor shall keep the government informed of when the integrity
item is initiated and when it is closed. Notice should be provided of the details
concerning any resolution and monetary payments as well as any settlement agreements or
corporate integrity agreements.






	 	3.	 	The PDP Sponsor agrees to provide notice based on best knowledge, information, and
belief to CMS in the event the Sponsor or any of its subcontractors is criminally convicted
or has a civil judgment entered against it for fraudulent activities or is sanctioned under
any Federal program involving the provision of





5





health care or prescription drug services.




	 	L.	 	LOW-INCOME SUBSIDY






PDP Sponsor agrees that it will participate in the administration of subsidies for low-income
individuals according to Subpart P of 42 CFR Part 423.




	 	M.	 	COMMUNICATION WITH CMS






PDP Sponsor agrees that it shall maintain the capacity to communicate with CMS electronically in
accordance with CMS requirements.




	 	N.	 	BENEFICIARY FINANCIAL PROTECTIONS






The PDP Sponsor agrees to afford its enrollees protection from liability for payment of fees
that are the obligation of the PDP Sponsor in accordance with 42 CFR §423.505(g).




	 	O.	 	RELATIONSHIP WITH RELATED ENTITIES, CONTRACTORS, AND






SUBCONTRACTORS




	 	1.	 	The PDP Sponsor agrees it maintains ultimate responsibility for adhering to and
otherwise fully complying with all terms and conditions of this contract with CMS.






	 	2.	 	The PDP Sponsor shall ensure that any contracts or agreements with subcontractors or
agents performing functions on the PDP Sponsor’s behalf related to the operation of the
Part D benefit are in compliance with 42 CFR §423.505(i).






	 	3.	 	The PDP Sponsor agrees to act in accordance with 45 CFR Part 76 and agrees that it will
not contract with or employ entities or individuals that are excluded by the Department of
Health and Human Services, Office of the Inspector General or included on the Excluded
Parties List System maintained by the General Services Administration.






	 	P.	 	CERTIFICATION OF DATA THAT DETERMINE PAYMENT






PDP Sponsor must provide certifications in accordance with 42 CFR §423.505(k).




	 	Q.	 	ENROLLMENT RELATED COSTS






PDP Sponsor agrees to payment of fees established by CMS for cost sharing of enrollment related
costs in accordance with 42 CFR §423.6.



6




Article III

Record Retention and Reporting Requirements





	 	A.	 	RECORD MAINTENANCE AND ACCESS






PDP Sponsor agrees to maintain records and provide access in accordance with 42 CFR
§§423.504(d), and 423.505(d) and (e).




	 	B.	 	GENERAL REPORTING REQUIREMENTS






The PDP Sponsor agrees to submit information to CMS according to 42 CFR §§423.505(f), 423.514,
and the “Final Medicare Part D Reporting Requirements,” a document issued by CMS and subject to
modification each program year.




	 	C.	 	LICENSURE-RELATED REPORTING REQUIREMENTS






	 	1.	 	If the PDP Sponsor is operating under a CMS-granted licensure waiver in any State, the
PDP Sponsor agrees to notify CMS in writing of the State’s disposition of the Sponsor’s
license application within ten business days of the date that it receives notice of the
State’s action.






	 	2.	 	For those States where the PDP Sponsor is operating under a risk-bearing license, the
Sponsor agrees to provide written notice to CMS of the State’s non-renewal of the Sponsor’s
license within ten days of receiving notice of the State’s action.






	 	3.	 	In the event that a State regulator imposes a sanction against the PDP Sponsor or
requires the implementation of a corrective action plan, the Sponsor agrees to provide
written notice to CMS of such sanction or corrective action requirement (including basis
for the sanction and/or timeline for corrective action) within ten days of receiving notice
of the State’s action.






	 	4.	 	In the event that there is a change in the status of the PDP Sponsor’s risk-bearing
license in any State (e.g., suspension, revocation), the Sponsor agrees to provide written
notice to CMS of the change in status (including basis for the change in status and
effective date) within ten days of receiving notice of the State’s action.






	 	5.	 	If the PDP Sponsor is operating a Part D benefit under a CMS-granted waiver in every
State in its service area, and the Sponsor is terminating or reducing the amount of an
existing letter of credit obtained for the purposes of funding projected losses, the
Sponsor shall provide written notice to CMS of such action 30 days prior to its effective
date. The PDP Sponsor agrees that it must obtain CMS approval prior to terminating or
reducing the amount of a letter of credit obtained for the purposes of funding projected
losses under Appendix X of the PDP Solicitation.






	 	D.	 	CMS License For Use of Plan Formulary






PDP Sponsor agrees to submit to CMS each plan’s formulary information, including any changes
to its formularies, and hereby grants to the Government[, and any person or entity who might
receive the formulary from the Government,]



7





a non-exclusive license to use all or any portion of the formulary for any purpose related
to the administration of the Part D program, including without limitation publicly
distributing, displaying, publishing or reconfiguration of the information in any medium,
including www.medicare.gov, and by any electronic, print or other means of distribution.



Article IV

HIPAA Provisions




HIPAA TRANSACTIONS/PRIVACY/SECURITY





	 	A.	 	PDP Sponsor agrees to comply with the confidentiality and enrollee record accuracy
requirements specified in 42 CFR §423.136.






	 	B.	 	PDP Sponsor agrees to enter into a business associate agreement with the entity with which
CMS has contracted to track Medicare beneficiaries’ true out-of- pocket costs.





Article V

Requirements of Other Laws and Regulations




The PDP Sponsor agrees to comply with (a) applicable Federal laws and regulations designed to
prevent fraud, waste, and abuse, including, but not limited to applicable provisions of Federal
criminal law, the False Claims Act (31 U.S.C. §§3729 et seq.), and the anti-kickback provision of
section 1128B of the Act; (b) applicable HIPAA Administrative Simplification Security and Privacy
rules at 45 CFR parts 160, 162, and 164; and (c) all other applicable Federal statutes and
regulations.



Article VI

Contract Term and Renewal





	 	A.	 	TERM OF CONTRACT






This contract is effective from the date of CMS’ authorized representative’s signature through
December 31, 2006. This contract shall be renewable for successive one-year periods thereafter
according to 42 CFR §423.506. PDP Sponsor shall not


conduct Part D-related marketing activities prior to October 1, 2005 and shall not process
enrollment applications prior to November 15, 2005. PDP Sponsor shall begin delivering
prescription drug benefit services on January 1, 2006.




	 	B.	 	QUALIFICATION TO RENEW A CONTRACT






	 	1.	 	In accordance with 42 CFR §423.507, the PDP Sponsor will be determined





8





qualified to renew its contract annually only if-




(a) CMS informs the PDP Sponsor that it is qualified to renew its




contract; and




	 	(b)	 	The PDP Sponsor has not provided CMS with a notice of intention






not to renew in accordance with Article VII of this contract.




	 	2.	 	Although PDP Sponsor may be determined qualified to renew its contract under this
Article, if the PDP Sponsor and CMS cannot reach agreement on the bid under Subpart F of 42
CFR Part 423, no renewal takes place, and the failure to reach agreement is not subject to
the appeals provisions in Subpart N of 42 CFR Part 423.





Article VII

Nonrenewal of Contract




A. NONRENEWAL BY THE PDP SPONSOR




	 	1.	 	The PDP Sponsor may elect not to renew its contract with CMS, effective at the






end of the term of the contract for any reason as long as PDP Sponsor provides proper notice of
the decision according to the required timeframes.




	 	2.	 	If the PDP Sponsor does not intend to renew its contract, it must






notify -




	 	(a)	 	CMS in writing by the first Monday of June in the year in which the current contract
period ends;






	 	(b)	 	Each Medicare enrollee, at least 90 days before the date on which the






nonrenewal is effective. This notice must include a written description of alternatives
available for obtaining qualified prescription drug coverage within the PDP region,
including Medicare Advantage-Prescription Drug plans,


Medicare cost plans offering a Part D plan, and other PDPs, and must receive CMS approval
prior to issuance; and




	 	(c)	 	The general public, at least 90 days before the end of the current calendar






year, by publishing a notice in one or more newspapers of general circulation in each
community or county located in the Part D plan sponsor’s service area.




	 	3.	 	If the PDP Sponsor does not renew a contract CMS cannot enter into a contract






with the organization for 2 years unless there are special circumstances that warrant special
consideration, as determined by CMS.




	 	4.	 	If the PDP Sponsor does not renew a contract, it must ensure the timely transfer of any data
or files in accordance with CMS instructions.






	 	B.	 	NONRENEWAL BY CMS






	 	1.	 	CMS may determine that the PDP Sponsor is not qualified to renew its contract for any
of the following reasons:






	 	(a)	 	The reasons listed in 42 CFR §423.509(a) that also permit CMS to terminate






the contract.




(b) The PDP Sponsor has committed any of the acts in 42 CFR §423.752 that



9





support the imposition of intermediate sanctions or civil money penalties under 42 CFR
§423.750.




	 	2.	 	CMS will provide notice of its decision whether the PDP Sponsor is qualified to renew its
contract as follows:






(i) To the PDP Sponsor by May 1 of the current contract year.




	 	(ii)	 	If CMS decides that the PDP Sponsor is not qualified to renew its contract, to






the PDP Sponsor’s Medicare enrollees by mail at least 90 days before the end of the current
calendar year.




(iii) If CMS determines that the PDP Sponsor is not qualified to renew its




contract, to the general public at least 90 days before the end of the current calendar
year, by publishing a notice in one or more newspapers of general circulation in each
community or county located in the PDP Sponsor’s service


area.




	 	(iv)	 	CMS will provide the notice described in (B)(2)(ii)and (iii) of this Article






where a non-renewal results because CMS and the PDP Sponsor are unable to reach agreement on
the bid under 42 CFR Part 423, Subpart F.




	 	3.	 	CMS shall give the PDP Sponsor written notice of its right to appeal the decision that the
sponsor is not qualified renew its contract in accordance with 42 CFR §423.642(b).





Article VIII

Modification or Termination of Contract





	 	A.	 	CONTRACT MODIFICATION OR TERMINATION BY MUTUAL CONSENT






	 	1.	 	This contract may be modified or terminated at any time by written mutual consent of
the parties.






	 	2.	 	If this contract is terminated by mutual consent, the PDP Sponsor must provide notice
to its Medicare enrollees and the general public in accordance with CMS’s instructions.






	 	3.	 	If the contract is modified by mutual consent, the PDP Sponsor must notify its Medicare
enrollees of any changes that CMS determines are appropriate for notification according to
the process and timeframes specified by CMS.






4. If a contract is terminated under section A of this Article, the PDP Sponsor




must ensure the timely transfer of any data or flies.




	 	B.	 	TERMINATION OF CONTRACT BY CMS






CMS may terminate the contract in accordance with 42 CFR §423.509.




	 	C.	 	TERMINATION OF CONTRACT BY THE PDP SPONSOR






The PDP Sponsor may terminate the contract only in accordance with 42 CFR §423.510.



10




Article IX

Intermediate Sanctions




Consistent with Subpart O of 42 CFR Part 423, the PDP Sponsor shall be subject to sanctions and
civil money penalties.



Article X

Severability




Severability of the contract shall be in accordance with 42 CFR 423.504(e).



Article XI

Miscellaneous





	 	A.	 	DEFINITIONS






Terms not otherwise defined in this contract shall have the meaning given to such terms in 42
CFR Part 423.




	 	B.	 	ALTERATION TO ORIGINAL CONTRACT TERMS






The PDP Sponsor agrees that it has not altered in any way the terms of the PDP contract
presented for signature by CMS. PDP Sponsor agrees that any alterations to the original text the
PDP Sponsor may make to this contract shall not be binding on the parties.




	 	C.	 	ADDITIONAL CONTRACT TERMS






The PDP Sponsor agrees to include in this contract other terms and conditions in accordance with
42 CFR §423.505(j).




	 	D.	 	CMS APPROVAL TO BEGIN MARKETING AND ENROLLMENT ACTIVITIES






PDP Sponsor agrees that it must complete CMS operational requirements prior to receiving CMS
approval to begin Part D marketing and enrollment activities. Such activities include, but are
not limited to, establishing and successfully testing connectivity, with CMS systems to process
enrollment applications (or contracting with an entity qualified to perform such functions on
PDP Sponsor’s behalf) and successfully demonstrating capability to submit accurate and timely
price comparison data. To establish and successfully test connectivity, the PDP Sponsor must, 1)
establish and test physical connectivity to the CMS data center, 2) acquire user identifications
and passwords, 3) receive, store, and maintain data necessary to



11




perform enrollments and send and receive transactions to and from CMS, and 4) check and receive
transaction status information.



12




In witness whereof, the parties hereby execute this contract.



FOR THE PDP SPONSOR



	 	 	 
	Todd S. Farha     

	 	President & C.E.O.     
	 

	 	 
	Printed Name

	 	Title
	 
	 	 
	/s/ Todd S. Farha      

	 	9-6-05     
	 

	 	 
	Signature

	 	Date






	 	 	 
	WellCare Prescription Insurance, Ine.8725 Henderson Road, Ren. 2 Tampa, FL 33634
	Organization Address





FOR THE CENTERS FOR MEDICARE & MEDICAID SERVICES



	 	 	 
	/s/ Cynthia Tudor for

	 	9/30/05     
	 

	 	 
	Robert Donnelly

	 	Date






Director


Medicare Drug Benefit Group


Center for Beneficiary Choices



13




ATTACHMENT A




PART D BENEFIT PLAN(S) — DESCRIPTION




14




Prescription Drug Plan Attestation of Benefit Plan and Price




WELLCARE HEALTH PLANS




S5967




Date: 09/06/2005




I attest that the following plan numbers as established in the final Plan Benefit Package (PBP)
will be operated by the above-stated organization and made available to eligible Medicare
beneficiaries in the approved service area during program year 2006.



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	035
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	23.96	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	036
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	20.59	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	037
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	17.13	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	038
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	17.17	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	039
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	19.80	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	040
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	21.20	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	041
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	22.85	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	042
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	24.87	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	043
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	25.71	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	044
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	24.91	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	045
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	18.70	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	046
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	26.46	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	047
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	24.49	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






Page 1 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	048
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	19.96	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	049
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	27.45	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	050
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	24.80	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	051
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	21.31	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	052
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	23.82	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	053
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	28.38	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	054
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	29.22	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	055
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	25.79	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	056
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	23.66	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	057
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	28.86	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	058
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	26.64	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	059
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	24.45	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	060
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	25.40	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	061
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	26.44	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	062
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	27.97	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






Page 2 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	063
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	20.84	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	064
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	28.14	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	065
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	32.73	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	066
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	18.04	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	067
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	19.18	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	068
	 	 	0	 	 	 	5	 	 	Signature
	 	Drug Plan
	 	Initial
	 	 	20.05	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	069
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	42.51	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	070
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	38.61	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	071
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	33.34	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	072
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	36.29	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	073
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	39.83	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	074
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	38.29	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	075
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	43.07	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	076
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.22	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	077
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.02	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






Page 3 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	078
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	44.69	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	079
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	38.44	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	080
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.10	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	081
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	42.16	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	082
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	41.56	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	083
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	47.99	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	084
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	42.24	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	085
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	40.97	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	086
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	44.29	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	087
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	46.96	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	088
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	49.46	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	089
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.06	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	090
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	44.91	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	092
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	47.25	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	093
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.66	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






Page 4 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	094
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	43.41	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	095
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	41.81	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	096
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.09	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	097
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	42.43	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	098
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	41.00	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	099
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	45.65	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	100
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	50.68	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	101
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	34.79	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	102
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	34.74	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	103
	 	 	0	 	 	 	2	 	 	Complete
	 	Drug Plan
	 	Initial
	 	 	40.41	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	104
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	45.48	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	105
	 	 	0	 	 	 	3	 	 	Premier e
	 	Drug Plan
	 	Initial
	 	 	41.25	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	106
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	35.49	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	107
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	38.82	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	108
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	42.67	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






Page 5 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	109
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	41.07	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	110
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	46.45	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	111
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.99	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	112
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.85	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	113
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.53	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	114
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	41.41	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	115
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.95	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	116
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	45.35	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	117
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	45.05	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	118
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	52.23	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	119
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	44.91	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	120
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	43.75	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	121
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	47.98	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	122
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	50.74	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	123
	 	 	0	 	 	 	3	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	53.70	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






Page 6 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	CMS	 	 
	Plan	 	Segment	 	 	 	 	 	Plan	 	 	 	 	 	Transaction	 	Part D	 	Approval	 	Effective
	ID	 	ID	 	Version	 	Name	 	Plan Type	 	Type	 	Premium	 	Date	 	Date
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	124
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.96	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	125
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.28	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	126
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	50.98	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	127
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.81	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	128
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	45.97	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	129
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	44.22	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	130
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.30	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	131
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	44.99	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	132
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	43.81	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	133
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	48.75	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	134
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	54.21	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	135
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	36.60	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	136
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	36.40	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicare
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	WellCare
	 	Prescription
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	137
	 	 	0	 	 	 	2	 	 	Premier
	 	Drug Plan
	 	Initial
	 	 	42.64	 	 	 	08/31/2005	 	 	 	01/01/2006	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 






	 	 	 
	/s/ Todd S. Farha     

	 	9/07/05     
	 

	 	 
	CEO:

	 	Date:






Page 7 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005




Todd Farha


CEO/President


PO Box 26011



Tampa, FL 336236011


888-888-9355



	 	 	 
	/s/ Paul Behrens     

	 	9/7/05     
	 

	 	 
	CFO:

	 	Date:






Paul Behrens

Chief Financial Officer


PO Box 26011



Tampa, FL 336225827


888-888-9355 (1469)



Page 8 – WELLCARE HEALTH PLANS – S5967 – 09/06/2005