EX-10.2






AMERIGROUP FLORIDA, INC. Medicaid HMO Contract



AHCA CONTRACT NO. FA523

AMENDMENT NO. 8




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



1. Standard Contract, Section II .A, Contract Amount, the first sentence is hereby amended to now
read:




To pay for contracted services according to the conditions of Attachment I in an amount not to
exceed $680,379,083.00, (an increase of $10,560,000.00), subject to the availability of funds.




	 	2.	 	Attachment I, Section 90.0, Payment and Authorized Enrollment Levels, Table 1 is hereby
amended to now read:






Table 1 Projected Enrollment



	 	 	 	 	 
	County	 	Maximum Enrollment Level
	BREVARD
	 	 	8,000	 
	 
	 	 	 	 
	BROWARD
	 	 	14,000	 
	 
	 	 	 	 
	_DADE
DADE
	 	 	25,000	 
	 
	 	 	 	 
	HILLSBOROUGH
	 	 	40,000	 
	 
	 	 	 	 
	LEE
	 	 	18,000	 
	 
	 	 	 	 
	MANATEE
	 	 	3,500	 
	 
	 	 	 	 
	ORANGE
	 	 	30,000	 
	 
	 	 	 	 
	OSCEOLA
	 	 	8,500	 
	 
	 	 	 	 
	PALM BEACH
	 	 	12,000	 
	 
	 	 	 	 
	PASCO
	 	 	15,000	 
	 
	 	 	 	 
	-PINELLAS
	 	 	25,000	 
	 
	 	 	 	 
	POLK
	 	 	30,000	 
	 
	 	 	 	 
	SARASOTA
	 	 	8,000	 
	 
	 	 	 	 
	SEMINOLELE
	 	 	8,000	 
	 
	 	 	 	 







	 	3.	 	Attachment I, Section 90.0, Payment and Authorized Enrollment Levels, Table 3, is hereby
amended to now read:





Table 3 Area



Age-banded Capitation Rates, Including Community Mental Health and Mental Health Targeted
Case Management



Table 3.


Areas 5, 6, 7, 8, 9, 10, and 11 Age-banded Capitation Rates, Including Community Mental Health
and Mental Health Targeted Case Management Area 05 General Rates plus Mental Health Plan -
015005304(PASCO) 015005305(PINELLAS)



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male
	 	21-54Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	345.77	 	 	 	79.28	 	 	 	51.94	 	 	 	57.32	 	 	 	114,31	 	 	 	139.01	 	 	 	210.44	 	 	 	291.84	 	 	 	291,84	 
	SSI/NO Medicare
	 	 	3265.63	 	 	 	429.24	 	 	 	240.86	 	 	 	235.59	 	 	 	235.59	 	 	 	628.37	 	 	 	628.37	 	 	 	594.95	 	 	 	594.95	 
	SSI/Part B
	 	 	266.87	 	 	 	266.81	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 
	SSI/Part A 6 B
	 	 	310.72	 	 	 	318.72	 	 	 	318.12	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318,72	 	 	 	318.72	 	 	 	225,77	 






Area 06 General Rates plus Mental Health Plan — 015005300(HILLSBOROUGH) 015005307(POLK) 015005318
(MANATEE)



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	<1 year	 	-5	 	6-13	 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male 21-54 Female	 	 	 	 	 	55-64	 	65+
	TANF/FC/SOBRA	 	330.07	 	7591	 	61.92	 	61.67	 	122.23	 	135.83	 	204.29	 	282.98	 	282.98
	SS1/No Medicare
	 	 	3017.05	 	 	 	37169	 	 	 	265.72	 	 	 	243.82	 	 	 	243,82	 	 	 	647.81	 	 	 	647.81	 	 	 	587,26	 	 	 	587.26	 
	SSI/Part B
	 	 	242.29	 	 	 	24229	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242,29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 
	SSI/Part A 6 B
	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288,09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	202.64	 






AHCA Contract No. FA523, Amendment No. 8, Page 1 of 3




AHCA Form 2100-0002 (Rev. NOV03)



1




AMERIGROUP FLORIDA, INC. Medicaid HMO Contract



Area 07 General Rates plus Mental Health Plan — 015005308 (ORANGE)
015005313(SEMINOLE) 015005314(OSCEOLA) 015005336(BREVARD)



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-:	 	 	 	6-13	 	 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male
	 	21-54Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	337.20	 	 	 	76.9	)	 	 	58.07	 	 	 	59.10	 	 	 	114.69	 	 	 	136.45	 	 	 	206.32	 	 	 	287.87	 	 	 	287.87	 
	SSI/No Medicare
	 	 	3217.90	 	 	 	406,81	 	 	 	260.45	 	 	 	239.73	 	 	 	239.73	 	 	 	628.24	 	 	 	628.24	 	 	 	594.96	 	 	 	594.96	 
	SSI/Part B
	 	 	266.03	 	 	 	266.0	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 
	SSI/Part A & B
	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	208.25	 






Area 08 General Rates plus Mental Health Plan — 015005302 (LEE) 015005306(SARASOTA)



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-3	 	 	 	6-13	 	 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male
	 	21-54Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	296.69	 	 	 	67.77	 	 		 46,25		 	 	49.88	 	 	 	98.88	 	 	 	119,48	 	 	 	180.88	 	 	 	251.72	 	 	 	251.72	 
	SSI/No Medicare
	 	 	3079.31	 	 	 	393.43	 	 	 	223.95	 	 	 	221.50	 	 	 	221.50	 	 	 	594.93	 	 	 	594,93	 	 	 	563.76	 	 	 	563,76	 
	SSI/Part B
	 	 	243.57	 	 	 	243.51	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 
	SSI/Part A 6 B
	 	 	292.10	 	 	 	292.30	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	206.49	 






Area 09 General Rates plus Mental Health Plan — 015005310(PALM BEACH)



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male
	 	21-54Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	316.80	 	 	 	71.49	 	 	 	49.26	 	 	 	52.54	 	 	 	104,85	 	 	 	126.25	 	 	 	191.61	 	 	 	270.11	 	 	 	270.11	 
	SSI/No Medicare
	 	 	3344.06	 	 	 	424,:3	 	 	 	246.02	 	 	 	236.61	 	 	 	236.61	 	 	 	650.12	 	 	 	650,12	 	 	 	614.45	 	 	 	614,45	 
	SSI/Part B
	 	 	267.44	 	 	 	267.+4	 	 	 	267,44	 	 	 	267.44	 	 	 	267.44	 	 	 	267.44	 	 	 	267.44	 	 	 	267.44	 	 	 	267.44	 
	SSI/Part A & B
	 	 	331.80	 	 	 	331.10	 	 	 	331.80	 	 	 	331.80	 	 	 	331.00	 	 	 	331.80	 	 	 	331.80	 	 	 	331,80	 	 	 	235.67	 






Area 10 General Rates plus Mental Health Plan — 015005311(BROWARD)



	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1.5	 	 		6-13		 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male 21-54 Female
	 	 	 	 	 		55-64		 	 	65+	 
	TANF/FC/SOBRA
	 	 	328.75	 	 	 	75.74	 	 	 	60.81	 	 	 	58.42	 	 	 	112.75	 	 	 	132.87	 	 	 	201.05	 	 	 	203.53	 	 	 	283.53	 
	SSI/No Medicare
	 	 	4151.83	 	 	 	510.2	 	 	 	323.61	 	 	 	304.08	 	 	 	304.08	 	 	 	801.75	 	 	 	801.75	 	 	 	764.03	 	 	 	764.03	 
	SSI/Part B
	 	 	290.18	 	 	 	290..0	 	 	 	290.18	 	 	 	290,16	 	 	 	290.18	 	 	 	290.18	 	 	 	290.18	 	 	 	290.18	 	 	 	290.18	 
	SSI/Part A & B
	 	 	354.95	 	 	 	354.15	 	 	 	354.95	 	 	 	354.95	 	 	 	354.95	 	 	 	354.95	 	 	 	354,95	 	 	 	354.95	 	 	 	249.35	 






	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 11 General Rates plus Mental ‘]Health Plan - 015005312(DADE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1.5	 	 	 	6-13	 	 	 	 	 	 	14-20 Male 14-20 Female 21-54 Male 21-54 Female
	 	 	 	 	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	409.17	 	 	 	92.16	 	 	 	69.70	 	 	 	69.26	 	 	 	136.84	 	 	 	161.91	 	 	 	246.27	 	 	 	343.39	 	 	 	343.39	 
	SSI/No Medicare
	 	 	4551.56	 	 	 	561.11	 	 	 	358.04	 	 	 	331.22	 	 	 	331.22	 	 	 	B76.41	 	 	 	876.41	 	 	 	832.73	 	 	 	832.73	 
	SSI/Part B
	 		451.58		 	 	451,58	 	 	 	451.58	 	 	 	451.58	 	 	 	451.58	 	 	 	451.58	 	 	 	451.50	 	 	 	451.58	 	 	 	451,58	 
	SSI/Part A & B
	 	 	420.30	 	 	 	420.10	 	 	 	420.30	 	 	 	420.30	 	 	 	420,30	 	 	 	420.30	 	 	 	420.30	 	 	 	420.30	 	 	 	295.40	 







	 	4.	 	Attachment I, Section 90.0, Payment and Authorized Enrollment Levels, Table 3, the second
paragraph is hereby amended to now read:






Notwithstanding the payment amounts which may be computed with the above rate table, the sum of
total capitation payments under this contract shall not exceed the total contract amount of
$680,379,083.00, (an increase of $10,560,000.00), expressed on page seven of this contract.




	 	5.	 	This amendment shall begin on July 1, 2005, or the date on which the amendment has been
signed by both parties, whichever is after.





All provisions in the Contract and any attachments thereto in conflict with this amendment
shall be and are hereby changed to con form 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 are hereby made a part of the Contract.



This amendment cam tot be executed unless all previous amendments to this Contract have been
fully executed.



No. 8, Page 2 of 3




AHCA Form 2100-0002 (Rev. NOV03)



AMERIGROUP FLORIDA, INC. Medicaid HMO Contract



IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.



AMERIGROUP FLORIDA, MC.




STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION



S.CONT



	 	 	 	 	 
	NAME: Don Gilmore
	 	NAME: Alan Levine
	 
	 	 	 	 
	 
	 	 
	 
	 	 	 	 
	TITLE: CEO

	 	 	 	TITLE: Secretary
	 

	 	 	 	 
	 
	 	 	 	 
	DATE:

	 	/s/ 6/21/05
	 	DATE:, /S/

6/27/05
	 

	 	 
	 	 







	 	 	 	THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY






AHCA Contract No. FA523, Amendment No. 8, Page 3 of 3



AHCA Form 2100-0002 (Rev. NOV03 )




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