staywellamendment8.htm


    
      Back to Form 8-K

      Exhibit 10.1

       

      WellCare
of Florida, Inc.
d/b/a           

      Staywell
Health Plan of
Florida                                                                              

       

       Medicaid
HMO Contract

    

    
      


       

      AHCA
CONTRACT NO. FA615

      AMENDMENT
NO. 8

    

    
      


       

      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 HEALTH PLAN OF FLORIDA, hereinafter referred to as
the "Vendor" or "Health Plan", is hereby amended as follows:

    

    
      


       

      
        	
                1.

              	
                Effective
      February 1, 2009, Attachment I, Scope of Services, is hereby amended to
      include Exhibit III-E, February 1, 2009 - August 31, 2009 Medicaid
      Non-Reform HMO Capitation Rates, attached hereto and made a part of the
      Contract. All references in the Contract to Exhibit III-D, September 1,
      2008 - August 31, 2009 Medicaid Non-Reform HMO Capitation Rates, shall
      hereinafter also refer to Exhibit III-E, February 1, 2009 -August 31, 2009
      Medicaid Non-Reform HMO Capitation Rates, as
  appropriate.

              


      

    

    
       

      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 are hereby made a 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 six (6) page Amendment (which includes all attachments
hereto) to be executed by their officials thereunto duly
authorized.

    

    
                                                                                               

    

    
      	
              WELLCARE
      OF FLORIDA, INC.

              D/B/A
      STAYWELL HEALTH PLAN 

              OF
      FLORIDA         

                                                                                         
    	
              STATE OF FLORIDA, AGENCY
      FOR

              HEALTH
      CARE ADMINISTRATION

               

            
	
              SIGNED

              BY: /s/
      Heath
      Schiesser                    
      

            	
              SIGNED

              BY:
      /s/ Name
      Illegible                         
      

            
	
              NAME:
      Heath
      Schiesser                  
      

            	
              NAME:
      for Holly
      Benson                  

            
	
              TITLE:
      President and
      CEO             
        

            	
              TITLE:
      Secretary                                 
      

            
	
              DATE: 2-17-09                                   
      

            	
              DATE:
      2/19/09                                     
      

            
	 
      	 
      


    

    
      


      List of
Attachments/Exhibits included as part of this Amendment:

    

    
       

    

    
      	
              
                Specify

              

              
                Type

              

            	
              
                Letter/

              

              
                Number

              

            	
              
                 

                Description

              

            
	
              
                Exhibit

              

            	
              
                III-E

              

            	
              
                February
      1, 2009 - August 31, 2009 Medicaid Non-Reform HMO

              

              
                Capitation
      Rates (5 pages)

              

            


    

    
      


       

      AHCA
Contract No. FA615, Amendment No. 8, Page 1 of 1

    

    
      AHCA Form
2100-0002 (Rev. NOV03)

    

    


    
      
        
           


        

        
           


          
            

          

        

        
           


        

      

    

     

    
      	
              EXHIBIT
      III-E

            
	
              February
      1, 2009 - August 31, 2009 HMO RATES

            
	
              (MEDICAID
      Non-Reform HMO CAPITATION RATES)

            
	
              By
      Area , Age and Eligibility Category

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      

              TABLE
      1

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
               
      

            	 
      	 
      	 
      	
              SSI-N

            	 
      	 
      	 
      	
              SSI-B

            	
              SSI-AB

            	 
      
	
              Area

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                      
      AGE (14-20)

            	
                  
      AGE (21-54)

            	
              AGE
      (55+)

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
              AGE
      (14-20)

            	
              AGE
      (21-54)

            	
              AGE
      (55+)

            	 
      	
              AGE
      (65-)

            	
              AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
              Female

            	
              Male

            	
              Female

            	
              Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,113.37

            	
              187.38

            	
              101.38

            	
              61.45

            	
              129.49

            	
              69.52

            	
              255.23

            	
              153.37

            	
              318.51

            	
              10,428.92

            	
              1,517.58

            	
              445.88

            	
              198.88

            	
              213.14

            	
              696.73

            	
              700.31

            	
              305.88

            	
              94.80

            	
              85.77

            
	
              02

            	
              1,113.37

            	
              187.38

            	
              101.38

            	
              61.45

            	
              129.49

            	
              69.52

            	
              255.23

            	
              153.37

            	
              318.51

            	
              10,428.92

            	
              1,517.58

            	
              445.88

            	
              198.88

            	
              213.14

            	
              696.73

            	
              700.31

            	
              305.88

            	
              94.80

            	
              85.77

            
	
              03

            	
              1,217.57

            	
              206.51

            	
              112.28

            	
              69.11

            	
              143.30

            	
              77.85

            	
              283.53

            	
              171.42

            	
              359.72

            	
              11,442.82

            	
              1,680.06

            	
              495.07

            	
              226.05

            	
              241.47

            	
              787.51

            	
              795.55

            	
              340.56

            	
              90.01

            	
              81.98

            
	
              04

            	
              1,067.51

            	
              181.92

            	
              99.04

            	
              61.51

            	
              126.30

            	
              69.23

            	
              250.83

            	
              152.26

            	
              321.21

            	
              10,972.58

            	
              1,615.28

            	
              476.38

            	
              218.79

            	
              233.36

            	
              761.37

            	
              770.55

            	
              297.82

            	
              90.35

            	
              82.40

            
	
              05

            	
              1,214.96

            	
              206.53

            	
              112.30

            	
              69.38

            	
              143.25

            	
              78.21

            	
              284.08

            	
              172.12

            	
              361.87

            	
              12,248.94

            	
              1,796.88

            	
              528.79

            	
              240.95

            	
              256.93

            	
              840.31

            	
              849.11

            	
              225.19

            	
              81.19

            	
              75.29

            
	
              06

            	
              1,056.56

            	
              181.19

            	
              98.87

            	
              61.99

            	
              126.18

            	
              69.68

            	
              251.35

            	
              153.20

            	
              325.45

            	
              11,162.18

            	
              1,645.44

            	
              485.06

            	
              223.95

            	
              237.92

            	
              777.94

            	
              788.05

            	
              274.94

            	
              79.31

            	
              72.63

            
	
              07

            	
              1,092.94

            	
              186.84

            	
              101.87

            	
              63.49

            	
              129.77

            	
              71.35

            	
              258.27

            	
              157.02

            	
              332.09

            	
              11,810.40

            	
              1,744.81

            	
              514.41

            	
              238.57

            	
              254.24

            	
              828.77

            	
              840.70

            	
              373.98

            	
              84.56

            	
              77.61

            
	
              08

            	
              1,033.51

            	
              177.08

            	
              96.67

            	
              60.37

            	
              123.15

            	
              68.03

            	
              245.23

            	
              149.29

            	
              316.91

            	
              10,525.98

            	
              1,550.30

            	
              457.03

            	
              210.03

            	
              224.35

            	
              731.36

            	
              740.14

            	
              256.24

            	
              78.77

            	
              72.23

            
	
              09

            	
              1,067.78

            	
              181.58

            	
              98.82

            	
              61.05

            	
              126.06

            	
              68.67

            	
              249.80

            	
              151.41

            	
              318.38

            	
              11,078.29

            	
              1,635.46

            	
              482.13

            	
              223.68

            	
              237.34

            	
              775.59

            	
              785.85

            	
              219.29

            	
              84.42

            	
              77.20

            
	
              10

            	
              1,083.46

            	
              186.09

            	
              101.73

            	
              63.88

            	
              129.70

            	
              71.87

            	
              258.53

            	
              157.78

            	
              335.92

            	
              14,344.29

            	
              2,132.34

            	
              629.36

            	
              297.17

            	
              314.18

            	
              1,027.07

            	
              1,044.85

            	
              322.21

            	
              94.02

            	
              86.21

            
	
              11

            	
              1,372.19

            	
              232.59

            	
              126.24

            	
              77.54

            	
              161.30

            	
              87.46

            	
              319.10

            	
              192.88

            	
              404.23

            	
              14,488.14

            	
              2,131.88

            	
              628.05

            	
              289.19

            	
              307.93

            	
              1,004.54

            	
              1,015.98

            	
              370.49

            	
              140.27

            	
              126.63

            
	
              6B*

            	
              1,056.42

            	
              181.17

            	
              98.86

            	
              61.98

            	
              126.16

            	
              69.67

            	
              251.32

            	
              153.18

            	
              325.40

            	
              11,161.68

            	
              1,645.35

            	
              485.04

            	
              223.94

            	
              237.91

            	
              777.89

            	
              788.02

            	
              274.94

            	
              79.31

            	
              72.63

            


    

     

    
      	
              TABLE
      2

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      + Mental Health Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
              SSI-N

            	 
      	 
      	 
      	
              SSI-B

            	
              SSI-AB

            	 
      
	
              Area

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                   
      AGE (14-20)

            	
                     AGE
      (21-54)

            	
              AGE
      (55+)

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
              AGE
      (14-20)

            	
              AGE
      (21-54)

            	
              AGE
      (55+)

            	 
      	
              AGE
      (65-)

            	
              AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
              Female

            	
                   
      Male

            	
              Female

            	
                  
      Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,113.39

            	
              187.40

            	
              103.02

            	
              73.14

            	
              140.42

            	
              80.45

            	
              259.67

            	
              157.81

            	
              322.25

            	
              10,429.00

            	
              1,517.66

            	
              453.32

            	
              246.93

            	
              257.13

            	
              778.13

            	
              731.29

            	
              306.09

            	
              106.45

            	
              97.42

            
	
              02

            	
              1,113.40

            	
              187.41

            	
              104.29

            	
              81.71

            	
              142.91

            	
              82.94

            	
              258.64

            	
              156.78

            	
              321.46

            	
              10,429.08

            	
              1,517.74

            	
              459.67

            	
              277.70

            	
              258.36

            	
              749.41

            	
              725.19

            	
              326.08

            	
              109.81

            	
              100.78

            
	
              03

            	
              1,217.58

            	
              206.52

            	
              113.60

            	
              78.29

            	
              149.38

            	
              83.93

            	
              285.07

            	
              172.96

            	
              361.06

            	
              11,442.89

            	
              1,680.13

            	
              501.33

            	
              261.81

            	
              261.99

            	
              811.41

            	
              806.83

            	
              347.41

            	
              98.99

            	
              90.96

            
	
              04

            	
              1,067.52

            	
              181.93

            	
              100.42

            	
              71.07

            	
              132.64

            	
              75.57

            	
              252.44

            	
              153.87

            	
              322.61

            	
              10,972.69

            	
              1,615.39

            	
              486.14

            	
              274.53

            	
              265.34

            	
              798.63

            	
              788.14

            	
              322.37

            	
              107.12

            	
              99.17

            
	
              05

            	
              1,214.97

            	
              206.54

            	
              113.51

            	
              78.06

            	
              151.36

            	
              86.32

            	
              287.37

            	
              175.41

            	
              364.65

            	
              12,248.99

            	
              1,796.93

            	
              533.81

            	
              273.37

            	
              286.61

            	
              895.23

            	
              870.01

            	
              227.92

            	
              94.01

            	
              88.11

            
	
              06

            	
              1,056.58

            	
              181.21

            	
              100.72

            	
              75.24

            	
              138.56

            	
              82.06

            	
              256.38

            	
              158.23

            	
              329.70

            	
              11,162.25

            	
              1,645.51

            	
              491.58

            	
              266.06

            	
              276.46

            	
              849.27

            	
              815.20

            	
              276.25

            	
              83.20

            	
              76.52

            
	
              07

            	
              1,092.96

            	
              186.86

            	
              103.65

            	
              76.18

            	
              141.63

            	
              83.21

            	
              263.09

            	
              161.84

            	
              336.16

            	
              11,810.46

            	
              1,744.87

            	
              520.53

            	
              278.08

            	
              290.41

            	
              895.70

            	
              866.18

            	
              376.57

            	
              95.08

            	
              88.13

            
	
              08

            	
              1,033.52

            	
              177.09

            	
              97.93

            	
              69.16

            	
              128.97

            	
              73.85

            	
              246.72

            	
              150.78

            	
              318.20

            	
              10,526.05

            	
              1,550.37

            	
              463.03

            	
              244.31

            	
              244.03

            	
              754.27

            	
              750.96

            	
              263.09

            	
              91.99

            	
              85.45

            
	
              09

            	
              1,067.80

            	
              181.60

            	
              100.37

            	
              71.86

            	
              133.22

            	
              75.83

            	
              251.62

            	
              153.23

            	
              319.95

            	
              11,078.36

            	
              1,635.53

            	
              488.46

            	
              259.82

            	
              258.08

            	
              799.75

            	
              797.26

            	
              226.14

            	
              94.01

            	
              86.79

            
	
              10

            	
              1,083.48

            	
              186.11

            	
              103.65

            	
              77.24

            	
              138.55

            	
              80.72

            	
              260.78

            	
              160.03

            	
              337.87

            	
              14,344.39

            	
              2,132.44

            	
              637.71

            	
              344.88

            	
              341.56

            	
              1,058.95

            	
              1,059.91

            	
              329.06

            	
              102.08

            	
              94.27

            
	
              11

            	
              1,372.21

            	
              232.61

            	
              127.86

            	
              88.83

            	
              168.79

            	
              94.95

            	
              321.01

            	
              194.79

            	
              405.88

            	
              14,488.22

            	
              2,131.96

            	
              635.02

            	
              328.99

            	
              330.76

            	
              1,031.14

            	
              1,028.54

            	
              377.72

            	
              148.33

            	
              134.69

            
	
              6B*

            	
              1,056.44

            	
              181.19

            	
              100.61

            	
              74.50

            	
              137.86

            	
              81.37

            	
              256.07

            	
              157.93

            	
              329.41

            	
              11,161.75

            	
              1,645.42

            	
              491.54

            	
              265.93

            	
              276.34

            	
              849.01

            	
              815.09

            	
              276.25

            	
              83.20

            	
              76.52

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
               

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


    

     

    
      AHCA
Contract No. FA615, Exhibit III-E, 1 of 5

       

    

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

     

    
      	
              EXHIBIT
      III-E

            
	
              February
      1. 2009 -August 31, 2009 HMO RATES

            
	
              (MEDICAID
      Non-Reform HMO CAPITATION RATES)

            
	
              By
      Area , Age and Eligibility Category

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              TABLE
      3

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      + MIH + Dental Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
              SSI-N

            	
               
      

            	 
      	 
      	 
      	 
      	
              SSI-B

            	
              SSI-AB

            	 
      
	
              Area

            	
              BTHMG+2MO

            	
               3MO-11MO

            	
                  AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                      
      AGE (14-20)

            	
               AGE
      (21-54)

            	
              AGE
      (55+)

            	
                BTHMO+2MO

            	
               3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
              AGE
      (14-20)

            	
              AGE
      (21-54)

            	
               AGE
      (55+)

            	
                  
      

            	
              AGE
      (65-)

            	
              AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
                  
      Female

            	
                   
      Male

            	
                 
      Female

            	
                 
      Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,113.39

            	
              187.41

            	
              104.70

            	
              76.25

            	
              143.60

            	
              83.14

            	
              260.89

            	
              159.07

            	
              325.04

            	
              10,429.00

            	
              1,517.66

            	
              454.94

            	
              249.33

            	
              259.19

            	
              779.46

            	
              733.15

            	
              306.54

            	
              107.57

            	
              98.28

            
	
              02

            	
              1,113.40

            	
              187.42

            	
              105.97

            	
              84.82

            	
              146.09

            	
              85.63

            	
              259.86

            	
              158.04

            	
              324.25

            	
              10,429.08

            	
              1,517.74

            	
              461.29

            	
              280.10

            	
              260.42

            	
              750.74

            	
              727.05

            	
              326.53

            	
              110.93

            	
              101.64

            
	
              03

            	
              1,217.59

            	
              206.54

            	
              116.65

            	
              83.95

            	
              155.15

            	
              88.81

            	
              286.81

            	
              174.74

            	
              365.03

            	
              11,442.89

            	
              1,680.14

            	
              504.46

            	
              266.45

            	
              265.98

            	
              813.29

            	
              809.48

            	
              348.44

            	
              100.64

            	
              92.22

            
	
              04

            	
              1,067.53

            	
              181.94

            	
              102.26

            	
              74.49

            	
              136.14

            	
              78.52

            	
              254.11

            	
              155.59

            	
              326.43

            	
              10,972.69

            	
              1,615.39

            	
              487.92

            	
              277.17

            	
              267.61

            	
              800.51

            	
              790.78

            	
              324.55

            	
              108.71

            	
              100.38

            
	
              05

            	
              1,214.98

            	
              206.56

            	
              116.92

            	
              84.39

            	
              157.83

            	
              91.79

            	
              290.78

            	
              178.92

            	
              372.44

            	
              12,249.00

            	
              1,796.94

            	
              538.03

            	
              279.64

            	
              291.99

            	
              898.93

            	
              875.21

            	
              231.58

            	
              97.80

            	
              91.00

            
	
              06

            	
              1.056.59

            	
              181.22

            	
              103.39

            	
              80.20

            	
              143.62

            	
              86.34

            	
              258.26

            	
              160.17

            	
              334.00

            	
              11,162.25

            	
              1,645.52

            	
              494.62

            	
              270.56

            	
              280.33

            	
              851.77

            	
              818.71

            	
              278.01

            	
              85.45

            	
              78.23

            
	
              07

            	
              1,092.97

            	
              186.87

            	
              106.05

            	
              80.63

            	
              146.17

            	
              87.05

            	
              264.42

            	
              163.20

            	
              339.20

            	
              11,810.46

            	
              1,744.88

            	
              523.53

            	
              282.52

            	
              294.23

            	
              897.25

            	
              868.36

            	
              377.05

            	
              96.60

            	
              89.29

            
	
              08

            	
              1,033.53

            	
              177.11

            	
              101.57

            	
              75.90

            	
              135.86

            	
              79.68

            	
              248.74

            	
              152.85

            	
              322.80

            	
              10,526.05

            	
              1,550.38

            	
              466.45

            	
              249.39

            	
              248.39

            	
              756.55

            	
              754.16

            	
              264.63

            	
              93.66

            	
              86.72

            
	
              09

            	
              1,067.81

            	
              181.62

            	
              103.30

            	
              77.30

            	
              138.78

            	
              80.53

            	
              252.58

            	
              154.21

            	
              322.14

            	
              11,078.36

            	
              1,635.54

            	
              491.05

            	
              263.67

            	
              261.39

            	
              800.93

            	
              798.91

            	
              227.97

            	
              95.08

            	
              87.60

            
	
              10

            	
              1,083.49

            	
              186.12

            	
              106.08

            	
              81.75

            	
              143.16

            	
              84.62

            	
              261.51

            	
              160.78

            	
              339.53

            	
              14,344.39

            	
              2,132.45

            	
              640.50

            	
              349.02

            	
              345.12

            	
              1,059.90

            	
              1,061.24

            	
              329.88

            	
              103.38

            	
              95.25

            
	
              11

            	
              1,372.22

            	
              232.62

            	
              131.59

            	
              96.51

            	
              176.76

            	
              101.67

            	
              321.87

            	
              195.67

            	
              407.84

            	
              14,488.23

            	
              2,131.98

            	
              639.29

            	
              336.38

            	
              337.23

            	
              1,032.92

            	
              1,031.04

            	
              381.06

            	
              150.49

            	
              136.34

            
	
              6B*

            	
              1,056.45

            	
              181.20

            	
              103.28

            	
              79.46

            	
              142.92

            	
              85.65

            	
              256.07

            	
              157.93

            	
              329.41

            	
              11,161.75

            	
              1,645.43

            	
              494.58

            	
              270.43

            	
              280.21

            	
              849.01

            	
              815.09

            	
              278.01

            	
              85.45

            	
              78.23

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


    

     

    
      	
              TABLE
      4

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      + MIH + Transportation Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
              SSI-N

            	 
      	 
      	 
      	
              SSI-B

            	
              SSI-AB

            	 
      
	
              Area

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                   
      AGE (14-20)

            	
                 
      AGE (21-54)

            	
              AGE
      (55+)

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                AGE
      (14-20)

            	
              AGE
      (21-54)

            	
              AGE
      (55+)

            	 
      	
              AGE
      (65-)

            	
              AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
              Female

            	
                   
      Male

            	
              Female

            	
                  
      Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,118.74

            	
              188.77

            	
              103.85

            	
              73.64

            	
              142.45

            	
              81.79

            	
              262.97

            	
              160.32

            	
              325.76

            	
              10,468.09

            	
              1,543.33

            	
              458.61

            	
              249.36

            	
              263.26

            	
              798.19

            	
              748.22

            	
              313.56

            	
              120.17

            	
              106.26

            
	
              02

            	
              1,118.75

            	
              188.78

            	
              105.12

            	
              82.21

            	
              144.94

            	
              84.28

            	
              261.94

            	
              159.29

            	
              324.97

            	
              10,468.17

            	
              1,543.41

            	
              464.96

            	
              280.13

            	
              264.49

            	
              769.47

            	
              742.12

            	
              333.55

            	
              123.53

            	
              109.62

            
	
              03

            	
              1,224.01

            	
              208.18

            	
              114.60

            	
              78.89

            	
              151.82

            	
              85.54

            	
              289.04

            	
              175.98

            	
              365.28

            	
              11,492.20

            	
              1,712.51

            	
              508.01

            	
              264.88

            	
              269.71

            	
              836.72

            	
              828.19

            	
              356.12

            	
              118.76

            	
              103.70

            
	
              04

            	
              1,072.09

            	
              183.11

            	
              101.13

            	
              71.50

            	
              134.38

            	
              76.72

            	
              255.26

            	
              156.01

            	
              325.61

            	
              11,011.02

            	
              1,640.55

            	
              491.32

            	
              276.91

            	
              271.34

            	
              818.29

            	
              804.74

            	
              329.55

            	
              122.97

            	
              109.39

            
	
              05

            	
              1,218.84

            	
              207.54

            	
              114.11

            	
              78.42

            	
              152.83

            	
              87.29

            	
              289.75

            	
              177.22

            	
              367.18

            	
              12,280.81

            	
              1,817.81

            	
              538.12

            	
              275.35

            	
              291.59

            	
              911.55

            	
              883.79

            	
              234.47

            	
              108.09

            	
              97.18

            
	
              06

            	
              1,060.38

            	
              182.19

            	
              101.31

            	
              75.60

            	
              140.00

            	
              83.01

            	
              258.73

            	
              160.02

            	
              332.19

            	
              11,193.75

            	
              1,666.20

            	
              495.85

            	
              268.01

            	
              281.39

            	
              865.43

            	
              828.84

            	
              281.96

            	
              94.76

            	
              83.97

            
	
              07

            	
              1,096.99

            	
              187.89

            	
              104.28

            	
              76.56

            	
              143.16

            	
              84.23

            	
              265.58

            	
              163.74

            	
              338.80

            	
              11,845.21

            	
              1,767.68

            	
              525.23

            	
              280.23

            	
              295.85

            	
              913.53

            	
              881.23

            	
              381.95

            	
              107.21

            	
              95.94

            
	
              08

            	
              1,038.81

            	
              178.45

            	
              98.76

            	
              69.66

            	
              130.99

            	
              75.18

            	
              249.98

            	
              153.26

            	
              321.67

            	
              10,564.27

            	
              1,575.46

            	
              468.20

            	
              246.69

            	
              250.01

            	
              773.87

            	
              767.52

            	
              269.02

            	
              106.78

            	
              94.97

            
	
              09

            	
              1,072.91

            	
              182.92

            	
              101.17

            	
              72.34

            	
              135.16

            	
              77.11

            	
              254.77

            	
              155.63

            	
              323.30

            	
              11,117.70

            	
              1,661.37

            	
              493.79

            	
              262.27

            	
              264.24

            	
              819.93

            	
              814.30

            	
              232.70

            	
              109.81

            	
              96.97

            
	
              10

            	
              1,086.47

            	
              186.89

            	
              104.12

            	
              77.52

            	
              139.69

            	
              81.47

            	
              262.62

            	
              161.43

            	
              339.83

            	
              14,370.64

            	
              2,149.68

            	
              641.26

            	
              346.51

            	
              345.67

            	
              1,072.41

            	
              1,071.28

            	
              334.36

            	
              114.42

            	
              102.22

            
	
              11

            	
              1,375.30

            	
              233.40

            	
              128.34

            	
              89.12

            	
              169.97

            	
              95.73

            	
              322.92

            	
              196.24

            	
              407.91

            	
              14,515.60

            	
              2,149.93

            	
              638.72

            	
              330.69

            	
              335.05

            	
              1,045.18

            	
              1,040.40

            	
              382.84

            	
              160.77

            	
              142.70

            
	
              6B*

            	
              1,060.24

            	
              182.17

            	
              101.20

            	
              74.86

            	
              139.30

            	
              82.32

            	
              258.42

            	
              159.72

            	
              331.90

            	
              11,193.25

            	
              1,666.11

            	
              495.81

            	
              267.88

            	
              281.27

            	
              865.17

            	
              828.73

            	
              281.96

            	
              94.76

            	
              83.97

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


    

     

    
      AHCA
Contract No. FA615, Exhibit III-E, 2 of 5

    

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

     

    
      	
              EXHIBIT
      lll-E

            
	
              February
      1, 2009 - August 31, 2009 HMO RATES

            
	
              (MEDICAID
      Non-Reform HMO CAPITATION RATES)

            
	
              By
      Area , Age and Eligibility Category

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              TABLE
      5

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      + Transportation Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
              SSI-N

            	 
      	 
      	
               
      

            	 
      	 
      	
              SSi-B

            	
              SSI-AB

            
	
              Area

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
                  
      AGE (6-13)       AGE
      (14-20)

            	
              AGE
      (21-54)

            	
              AGE
      (55+)

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
              AGE
      (14-20)

            	
               AGE
      (21-54)

            	
              AGE
      (55+)

            	 
      	
              AGE
      (65-)

            	
                AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
                      
      Female

            	
                    
      Male

            	
                   
      Female

            	
                  
      Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,118.72

            	
              188.75

            	
              102.21

            	
              61.95

            	
              131.52

            	
              70.86

            	
              258.53

            	
              155.88

            	
              322.02

            	
              10,468.01

            	
              1,543.25

            	
              451.17

            	
              201.31

            	
              219.27

            	
              716.79

            	
              717.24

            	
              313.35

            	
              108.52

            	
              94.61

            
	
              02

            	
              1,118.72

            	
              188.75

            	
              102.21

            	
              61.95

            	
              131.52

            	
              70.86

            	
              258.53

            	
              155.88

            	
              322.02

            	
              10,468.01

            	
              1,543.25

            	
              451.17

            	
              201.31

            	
              219.27

            	
              716.79

            	
              717.24

            	
              313.35

            	
              108.52

            	
              94.61

            
	
              03

            	
              1,224.00

            	
              208.17

            	
              113.28

            	
              69.71

            	
              145.74

            	
              79.46

            	
              287.50

            	
              174.44

            	
              363.94

            	
              11,492.13

            	
              1,712.44

            	
              501.75

            	
              229.12

            	
              249.19

            	
              812.82

            	
              816.91

            	
              349.27

            	
              109.78

            	
              94.72

            
	
              04

            	
              1,072.08

            	
              183.10

            	
              99.75

            	
              61.94

            	
              128.04

            	
              70.38

            	
              253.65

            	
              154.40

            	
              324.21

            	
              11,010.91

            	
              1,640.44

            	
              481.56

            	
              221.17

            	
              239.36

            	
              781.03

            	
              787.15

            	
              305.00

            	
              106.20

            	
              92.62

            
	
              05

            	
              1,218.83

            	
              207.53

            	
              112.90

            	
              69.74

            	
              144.72

            	
              79.18

            	
              286.46

            	
              173.93

            	
              364.40

            	
              12,280.76

            	
              1,817.76

            	
              533.10

            	
              242.93

            	
              261.91

            	
              856.63

            	
              862.89

            	
              231.74

            	
              95.27

            	
              84.36

            
	
              06

            	
              1,060.36

            	
              182.17

            	
              99.46

            	
              62.35

            	
              127.62

            	
              70.63

            	
              253.70

            	
              154.99

            	
              327.94

            	
              11,193.68

            	
              1,666.13

            	
              489.33

            	
              225.90

            	
              242.85

            	
              794.10

            	
              801.69

            	
              280.65

            	
              90.87

            	
              80.08

            
	
              07

            	
              1,096.97

            	
              187.87

            	
              102.50

            	
              63.87

            	
              131.30

            	
              72.37

            	
              260.76

            	
              158.92

            	
              334.73

            	
              11,845.15

            	
              1,767.62

            	
              519.11

            	
              240.72

            	
              259.68

            	
              846.60

            	
              855.75

            	
              379.36

            	
              96.69

            	
              85.42

            
	
              08

            	
              1,038.80

            	
              178.44

            	
              97.50

            	
              60.87

            	
              125.17

            	
              69.36

            	
              248.49

            	
              151.77

            	
              320.38

            	
              10,564.20

            	
              1,575.39

            	
              462.20

            	
              212.41

            	
              230.33

            	
              750.96

            	
              756.70

            	
              262.17

            	
              93.56

            	
              81.75

            
	
              09

            	
              1,072.89

            	
              182.90

            	
              99.62

            	
              61.53

            	
              128.00

            	
              69.95

            	
              252.95

            	
              153.81

            	
              321.73

            	
              11,117.63

            	
              1,661.30

            	
              487.46

            	
              226.13

            	
              243.50

            	
              795.77

            	
              802.89

            	
              225.85

            	
              100.22

            	
              87.38

            
	
              10

            	
              1,086.45

            	
              186.87

            	
              102.20

            	
              64.16

            	
              130.84

            	
              72.62

            	
              260.37

            	
              159.18

            	
              337.88

            	
              14,370.54

            	
              2,149.58

            	
              632.91

            	
              298.80

            	
              318.29

            	
              1,040.53

            	
              1,056.22

            	
              327.51

            	
              106.36

            	
              94.16

            
	
              11

            	
              1,375.28

            	
              233.38

            	
              126.72

            	
              77.83

            	
              162.48

            	
              88.24

            	
              321.01

            	
              194.33

            	
              406.26

            	
              14,515.52

            	
              2,149.85

            	
              631.75

            	
              290.89

            	
              312.22

            	
              1,018.58

            	
              1,027.84

            	
              375.61

            	
              152.71

            	
              134.64

            
	
              6B*

            	
              1,060.22

            	
              182.15

            	
              99.45

            	
              62.34

            	
              127.60

            	
              70.62

            	
              253.67

            	
              154.97

            	
              327.89

            	
              11,193.18

            	
              1,666.04

            	
              489.31

            	
              225.89

            	
              242.84

            	
              794.05

            	
              801.66

            	
              280.65

            	
              90.87

            	
              80.08

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


    

     

    
      	
              TABLE
      6

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      + Dental Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
              SSI-N

            	 
      	 
      	 
      	 
      	 
      	
              SSI-B

            	
              SSS-AB

            
	
              Area

            	
              BTHMO+2MO

            	
                3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                 
      AGE (14-20)

            	
                 AG
      E (21-54)

            	
              AGE
      (55+)

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
              AGE
      (14-20)

            	
              AGE
      (21-54)

            	
              AGE
      (55+)

            	 
      	
              AGE
      (65-)

            	
                 AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
               
      Female

            	
                   
        Male

            	
                  
      Female

            	
                
        Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,113.37

            	
              187.39

            	
              103.06

            	
              64.56

            	
              132.67

            	
              72.21

            	
              256.45

            	
              154.63

            	
              321.30

            	
              10,428.92

            	
              1,517.58

            	
              447.50

            	
              201.28

            	
              215.20

            	
              698.06

            	
              702.17

            	
              306.33

            	
              95.92

            	
              86.63

            
	
              02

            	
              1,113.37

            	
              187.39

            	
              103.06

            	
              64.56

            	
              132.67

            	
              72.21

            	
              256.45

            	
              154.63

            	
              321.30

            	
              10,428.92

            	
              1,517.58

            	
              447.50

            	
              201.28

            	
              215.20

            	
              698.06

            	
              702.17

            	
              306.33

            	
              95.92

            	
              86.63

            
	
              03

            	
              1,217.58

            	
              206.53

            	
              115.33

            	
              74.77

            	
              149.07

            	
              82.73

            	
              285.27

            	
              173.20

            	
              363.69

            	
              11,442.82

            	
              1,680.07

            	
              498.20

            	
              230.69

            	
              245.46

            	
              789.39

            	
              798.20

            	
              341.59

            	
              91.66

            	
              83.24

            
	
              04

            	
              1,067.52

            	
              181.93

            	
              100.88

            	
              64.93

            	
              129.80

            	
              72.18

            	
              252.50

            	
              153.98

            	
              325.03

            	
              10,972.58

            	
              1,615.28

            	
              478.16

            	
              221.43

            	
              235.63

            	
              763.25

            	
              773.19

            	
              300.00

            	
              91.94

            	
              83.61

            
	
              05

            	
              1,214.97

            	
              206.55

            	
              115.71

            	
              75.71

            	
              149.72

            	
              83.68

            	
              287.49

            	
              175.63

            	
              369.66

            	
              12,248.95

            	
              1,796.89

            	
              533.01

            	
              247.22

            	
              262.31

            	
              844.01

            	
              854.31

            	
              228.85

            	
              84.98

            	
              78.18

            
	
              06

            	
              1,056.57

            	
              181.20

            	
              101.54

            	
              66.95

            	
              131.24

            	
              73.96

            	
              253.23

            	
              155.14

            	
              329.75

            	
              11,162.18

            	
              1,645.45

            	
              488.10

            	
              228.45

            	
              241.79

            	
              780.44

            	
              791.56

            	
              276.70

            	
              81.56

            	
              74.34

            
	
              07

            	
              1,092.95

            	
              186.85

            	
              104.27

            	
              67.94

            	
              134.31

            	
              75.19

            	
              259.60

            	
              158.38

            	
              335.13

            	
              11,810.40

            	
              1,744.82

            	
              517.41

            	
              243.01

            	
              258.06

            	
              830.32

            	
              842.88

            	
              374.46

            	
              86.08

            	
              78.77

            
	
              08

            	
              1,033.52

            	
              177.10

            	
              100.31

            	
              67.11

            	
              130.04

            	
              73.86

            	
              247.25

            	
              151.36

            	
              321.51

            	
              10,525.98

            	
              1,550.31

            	
              460.45

            	
              215.11

            	
              228.71

            	
              733.64

            	
              743.34

            	
              257.78

            	
              80.44

            	
              73.50

            
	
              09

            	
              1,067.79

            	
              181.60

            	
              101.75

            	
              66.49

            	
              131.62

            	
              73.37

            	
              250.76

            	
              152.39

            	
              320.57

            	
              11,078.29

            	
              1,635.47

            	
              484.72

            	
              227.53

            	
              240.65

            	
              776.77

            	
              787.50

            	
              221.12

            	
              85.49

            	
              78.01

            
	
              10

            	
              1,083.47

            	
              186.10

            	
              104.16

            	
              68.39

            	
              134.31

            	
              75.77

            	
              259.26

            	
              158.53

            	
              337.58

            	
              14,344.29

            	
              2,132.35

            	
              632.15

            	
              301.31

            	
              317.74

            	
              1,028.02

            	
              1,046.18

            	
              323.03

            	
              95.32

            	
              87.19

            
	
              11

            	
              1,372.20

            	
              232.60

            	
              129.97

            	
              85.22

            	
              169.27

            	
              94.18

            	
              319.96

            	
              193.76

            	
              406.19

            	
              14,488.15

            	
              2,131.90

            	
              632.32

            	
              296.58

            	
              314.40

            	
              1,006.32

            	
              1,018.48

            	
              373.83

            	
              142.43

            	
              128.28

            
	
              6B*

            	
              1,056.43

            	
              181.18

            	
              101.53

            	
              66.94

            	
              131.22

            	
              73.95

            	
              251.32

            	
              153.18

            	
              325.40

            	
              11,161.68

            	
              1,645.36

            	
              488.08

            	
              228.44

            	
              241.78

            	
              777.89

            	
              788.02

            	
              276.70

            	
              81.56

            	
              74.34

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
               

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


    

     

    
      AHCA
Contract No. FA615, Exhibit III-E, 3 of 5

    

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

     

    
      	
              EXHIBIT
      III-E

            
	
              February
      1, 2009 -August 31, 2009 HMO RATES

            
	
              (MEDICAID
      Non-Reform HMO CAPITATION
      RATES)

            
	
              By
      Area , Age and Eligibility Category

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              TABLE
      7

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              General
      + Dental + Transportation Rates:

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
              TANF

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
              SSI-N

            	 
      	 
      	 
      	 
      	 
      	
              SSI-B

            	
              SSI-AB

            
	
              Area

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE
      (6-13)

            	
                
          AGE (14-20)

            	
                    AG
      E (21-54)

            	
              AGE
      (55+)

            	
              BTHMO+2MO

            	
              3MO-11MO

            	
              AGE
      (1-5)

            	
              AGE(6-13)

            	
              AGE
      (14-20)

            	
              AGE
      (21-54)

            	
              AGE
      (55+)

            	 
      	
              AGE
      (65-)

            	
               AGE
      (65+)

            
	 
      	 
      	 
      	 
      	 
      	
                   
      Female

            	
                   
      Male

            	
                  
      Female

            	
                 
      Male

            	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
              01

            	
              1,118.72

            	
              188.76

            	
              103.89

            	
              65.06

            	
              134.70

            	
              73.55

            	
              259.75

            	
              157.14

            	
              324.81

            	
              10,468.01

            	
              1,543.25

            	
              452.79

            	
              203.71

            	
              221.33

            	
              718.12

            	
              719.10

            	
              313.80

            	
              109.64

            	
              95.47

            
	
              02

            	
              1,118.72

            	
              188.76

            	
              103.89

            	
              65.06

            	
              134.70

            	
              73.55

            	
              259.75

            	
              157.14

            	
              324.81

            	
              10,468.01

            	
              1,543.25

            	
              452.79

            	
              203.71

            	
              221.33

            	
              718.12

            	
              719.10

            	
              313.80

            	
              109.64

            	
              95.47

            
	
              03

            	
              1,224.01

            	
              208.19

            	
              116.33

            	
              75.37

            	
              151.51

            	
              84.34

            	
              289.24

            	
              176.22

            	
              367.91

            	
              11,492.13

            	
              1,712.45

            	
              504.88

            	
              233.76

            	
              253.18

            	
              814.70

            	
              819.56

            	
              350.30

            	
              111.43

            	
              95.98

            
	
              04

            	
              1,072.09

            	
              183.11

            	
              101.59

            	
              65.36

            	
              131.54

            	
              73.33

            	
              255.32

            	
              156.12

            	
              328.03

            	
              11,010.91

            	
              1,640.44

            	
              483.34

            	
              223.81

            	
              241.63

            	
              782.91

            	
              789.79

            	
              307.18

            	
              107.78

            	
              93.83

            
	
              05

            	
              1,218.84

            	
              207.55

            	
              116.31

            	
              76.07

            	
              151.19

            	
              84.65

            	
              289.87

            	
              177.44

            	
              372.19

            	
              12,280.77

            	
              1,817.77

            	
              537.32

            	
              249.20

            	
              267.29

            	
              860.33

            	
              868.09

            	
              235.40

            	
              99.06

            	
              87.25

            
	
              06

            	
              1,060.37

            	
              182.18

            	
              102.13

            	
              67.31

            	
              132.68

            	
              74.91

            	
              255.58

            	
              156.93

            	
              332.24

            	
              11,193.68

            	
              1,666.14

            	
              492.37

            	
              230.40

            	
              246.72

            	
              796.60

            	
              805.20

            	
              282.41

            	
              93.12

            	
              81.79

            
	
              07

            	
              1,096.98

            	
              187.88

            	
              104.90

            	
              68.32

            	
              135.84

            	
              76.21

            	
              262.09

            	
              160.28

            	
              337.77

            	
              11,845.15

            	
              1,767.63

            	
              522.11

            	
              245.16

            	
              263.50

            	
              848.15

            	
              857.93

            	
              379.84

            	
              98.21

            	
              86.58

            
	
              08

            	
              1,038.81

            	
              178.46

            	
              101.14

            	
              67.61

            	
              132.06

            	
              75.19

            	
              250.51

            	
              153.84

            	
              324.98

            	
              10,564.20

            	
              1,575.40

            	
              465.62

            	
              217.49

            	
              234.69

            	
              753.24

            	
              759.90

            	
              263.71

            	
              95.23

            	
              83.02

            
	
              09

            	
              1,072.90

            	
              182.92

            	
              102.55

            	
              66.97

            	
              133.56

            	
              74.65

            	
              253.91

            	
              154.79

            	
              323.92

            	
              11,117.63

            	
              1,661.31

            	
              490.05

            	
              229.98

            	
              246.81

            	
              796.95

            	
              804.54

            	
              227.68

            	
              101.29

            	
              88.19

            
	
              10

            	
              1,086.46

            	
              186.88

            	
              104.63

            	
              68.67

            	
              135.45

            	
              76.52

            	
              261.10

            	
              159.93

            	
              339.54

            	
              14,370.54

            	
              2,149.59

            	
              635.70

            	
              302.94

            	
              321.85

            	
              1,041.48

            	
              1,057.55

            	
              328.33

            	
              107.66

            	
              95.14

            
	
              11

            	
              1,375.29

            	
              233.39

            	
              130.45

            	
              85.51

            	
              170.45

            	
              94.96

            	
              321.87

            	
              195.21

            	
              408.22

            	
              14,515.53

            	
              2,149.87

            	
              636.02

            	
              298.28

            	
              318.69

            	
              1,020.36

            	
              1,030.34

            	
              378.95

            	
              154.87

            	
              136.29

            
	
              6B*

            	
              1,060.23

            	
              182.16

            	
              102.12

            	
              67.30

            	
              132.66

            	
              74.90

            	
              253.67

            	
              154.97

            	
              327.89

            	
              11,193.18

            	
              1,666.05

            	
              492.35

            	
              230.39

            	
              246.71

            	
              794.05

            	
              801.66

            	
              282.41

            	
              93.12

            	
              81.79

            
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


    

     

    
      
        	 
      

                TABLE
      8

              	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
                General
      + Mental Health + Dental + Transportation Rates:

              	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	
                TANF

              	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	
                SSI-N

              	 
      	 
      	 
      	 
      	 
      	
                SSI-B

              	
                SSE-AB

              
	
                Area

              	
                BTHMO+2MO

              	
                3MO-11MO      AGE
      (1-5)

              	
                AGE
      (6-13)

              	
                AGE
      (14-20)

              	
                AGE
      (21-54)

              	
                AGE
      (55+)

              	
                BTHMO+2MO

              	
                3MO-11MO

              	
                AGE
      (1-5)

              	
                AGE
      (6-13)

              	
                AGE
      (14-20)

              	
                AGE
      (21-54)

              	
                AGE
      (55+)

              	 
      	
                AGE
      (65-)

              	
                  AGE
      (65+)

              
	 
      	 
      	 
      	 
      	 
      	
                     
      Female

              	
                     
      Male

              	
                    
      Female

              	
                   
      Male

              	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	
                01

              	
                1,118.74

              	
                188.78

              	
                105.53

              	
                76.75

              	
                145.63

              	
                84.48

              	
                264.19

              	
                161.58

              	
                328.55

              	
                10,468.09

              	
                1,543.33

              	
                460.23

              	
                251.76

              	
                265.32

              	
                799.52

              	
                750.08

              	
                314.01

              	
                121.29

              	
                107.12

              
	
                02

              	
                1,118.75

              	
                188.79

              	
                106.80

              	
                85.32

              	
                148.12

              	
                86.97

              	
                263.16

              	
                160.55

              	
                327.76

              	
                10,468.17

              	
                1,543.41

              	
                466.58

              	
                282.53

              	
                266.55

              	
                770.80

              	
                743.98

              	
                334.00

              	
                124.65

              	
                110.48

              
	
                03

              	
                1,224.02

              	
                208.20

              	
                117.65

              	
                84.55

              	
                157.59

              	
                90.42

              	
                290.78

              	
                177.76

              	
                369.25

              	
                11,492.20

              	
                1,712.52

              	
                511.14

              	
                269.52

              	
                273.70

              	
                838.60

              	
                830.84

              	
                357.15

              	
                120.41

              	
                104.96

              
	
                04

              	
                1,072.10

              	
                183.12

              	
                102.97

              	
                74.92

              	
                137.88

              	
                79.67

              	
                256.93

              	
                157.73

              	
                329.43

              	
                11,011.02

              	
                1,640.55

              	
                493.10

              	
                279.55

              	
                273.61

              	
                820.17

              	
                807.38

              	
                331.73

              	
                124.56

              	
                110.60

              
	
                05

              	
                1,218.85

              	
                207.56

              	
                117.52

              	
                84.75

              	
                159.30

              	
                92.76

              	
                293.16

              	
                180.73

              	
                374.97

              	
                12,280.82

              	
                1,817.82

              	
                542.34

              	
                281.62

              	
                296.97

              	
                915.25

              	
                888.99

              	
                238.13

              	
                111.88

              	
                100.07

              
	
                06

              	
                1,060.39

              	
                182.20

              	
                103.98

              	
                80.56

              	
                145.06

              	
                87.29

              	
                260.61

              	
                161.96

              	
                336.49

              	
                11,193.75

              	
                1,666.21

              	
                498.89

              	
                272.51

              	
                285.26

              	
                867.93

              	
                832.35

              	
                283.72

              	
                97.01

              	
                85.68

              
	
                07

              	
                1,097.00

              	
                187.90

              	
                106.68

              	
                81.01

              	
                147.70

              	
                88.07

              	
                266.91

              	
                165.10

              	
                341.84

              	
                11,845.21

              	
                1,767.69

              	
                528.23

              	
                284.67

              	
                299.67

              	
                915.08

              	
                883.41

              	
                382.43

              	
                108.73

              	
                97.10

              
	
                08

              	
                1,038.82

              	
                178.47

              	
                102.40

              	
                76.40

              	
                137.88

              	
                81.01

              	
                252.00

              	
                155.33

              	
                326.27

              	
                10,564.27

              	
                1,575.47

              	
                471.62

              	
                251.77

              	
                254.37

              	
                776.15

              	
                770.72

              	
                270.56

              	
                108.45

              	
                96.24

              
	
                09

              	
                1,072.92

              	
                182.94

              	
                104.10

              	
                77.78

              	
                140.72

              	
                81.81

              	
                255.73

              	
                156.61

              	
                325.49

              	
                11,117.70

              	
                1,661.38

              	
                496.38

              	
                266.12

              	
                267.55

              	
                821.11

              	
                815.95

              	
                234.53

              	
                110.88

              	
                97.78

              
	
                10

              	
                1,086.48

              	
                186.90

              	
                106.55

              	
                82.03

              	
                144.30

              	
                85.37

              	
                263.35

              	
                162.18

              	
                341.49

              	
                14,370.64

              	
                2,149.69

              	
                644.05

              	
                350.65

              	
                349.23

              	
                1,073.36

              	
                1,072.61

              	
                335.18

              	
                115.72

              	
                103.20

              
	
                11

              	
                1,375.31

              	
                233.41

              	
                132.07

              	
                96.80

              	
                177.94

              	
                102.45

              	
                323.78

              	
                197.12

              	
                409.87

              	
                14,515.61

              	
                2,149.95

              	
                642.99

              	
                338.08

              	
                341.52

              	
                1,046.96

              	
                1,042.90

              	
                386.18

              	
                162.93

              	
                144.35

              
	
                6B*

              	
                1,060.25

              	
                182.18

              	
                103.87

              	
                79.82

              	
                144.36

              	
                86.60

              	
                258.42

              	
                159.72

              	
                331.90

              	
                11,193.25

              	
                1,666.12

              	
                498.85

              	
                272.38

              	
                285.14

              	
                865.17

              	
                828.73

              	
                283.72

              	
                97.01

              	
                85.68

              
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      
	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      	 
      


      

    

     

    
      AHCA
Contract No. FA615, Exhibit III-E, 4 of 5

    

    


    
      
        
           


        

        
           


          
            

          

        

        
           


        

      

    

    


    EXHIBIT
III-E

    
      
         

         

        February
1,  2009
- August 31, 2009 HMO RATES

      

      
        (MEDICAID
Non-Reform HMO CAPITATION RATES)

      

      
        By
Area , Age and Eligibility Category

      

      
        


      

      
        	
                Area

              	
                Corresponding
      Counties

                 

              
	
                Area
      1

              	
                Escambia,
      Okaloosa, Santa Ross, Walton

              
	
                 

                Area
      2

              	
                 

                Bay,
      Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon,
      Liberty, Madison, Taylor, Washington, Wakulla

              
	
                 

                Area
      3

              	
                 

                Alachua,
      Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando,
      Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee,
    Union

              
	
                 

                Ares
      4

              	
                 

                Baker,
      Clay, Duval, Flagler, Nassau, St. Johns, Volusia

              
	
                 

                Area
      5

              	
                 

                Pasco,
      Pinellas

              
	
                 

                Area
      6

              	
                 

                Hardee,
      Highlands, Manatee, Polk

              
	
                 

                Area
      6B *

              	
                 

                Hillsborough

              
	
                 

                Area
      7

              	
                 

                Brevard,
      Orange, Osceola, Seminole

              
	
                 

                Area
      8

              	
                 

                Charlotte,
      Collier, De Soto, Glades, Hendry, Lee, Sarasota

              
	
                 

                Area
      9

              	
                 

                Indian
      River, Okeechobee, St. Lucie, Martin, Palm Beach

              
	
                 

                Ares
      10

              	
                 

                Broward

              
	
                 

                Area
      11

              	
                 

                Dade,
      Monroe

              


      

      
        


         

        AHCA
Contract No. FA615, Exhibit III-E, 5 of
5