fa615amend2.htm


    
      

    

    Back
      to Form 8-K

    Exhibit
      10.2


    AHCA
      CONTRACT NO. FA615

    AMENDMENT
      NO. 2

    


    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.

            	
              Standard
                Contract, Section III, Item C., Contract Managers, sub-item 2. is
                hereby
                amended to now read as follows:

            


    

    


    
      	
               

            	
              2.

            	
              The
                Vendor’s Contract Manager’s name, address and telephone number for this
                Contract is as follows:

            


    

    


    
      	
               

            	
              Geoffrey
                L. Petrie

            


    

    
      	
               

            	
              WellCare
                of Florida, Inc. d/b/a Staywell Health Plan of
                Florida

            


    

    
      	
               

            	
              8735
                Henderson Road

            


    

    
      	
               

            	
              Tampa,
                FL  33614-3988

            


      	 	(813)
              865-5038


    

     

    
      	
              2.

            	
              Attachment
                I, Scope of Services, is hereby amended to include Exhibit II-B,
                Second
                Revised Capitation Rates, attached hereto and made a part of the
                Contract.  All references in the Contract to Exhibit II-A,
                Revised Capitation Rates, shall hereinafter also refer to Exhibit
                II-B,
                Second Revised Capitation Rates, as
                appropriate.

            


    

    


    
      	
              3.

            	
              Attachment
                I, Scope of Services, is hereby amended to include Exhibit III-A,
                September 1, 2007- August 31, 2008 Medicaid Non-Reform HMO Capitation
                Rates, attached hereto and made a part of the Contract.  All
                references in the Contract to Exhibit III, September 1, 2006 – August 31,
                2007 HMO Rates, shall hereinafter also refer to Exhibit III-A, September
                1, 2007- August 31, 2008 Medicaid Non-Reform HMO Capitation Rates,
                as
                appropriate.

            


    

    


    
      	
              4.

            	
              Attachment
                II, Medicaid Prepaid Health Plan Model Contract, Section V, Covered
                Services, Item C, Expanded Services, sub-item 2 is hereby deleted
                in its
                entirety and replaced with the
                following:

            


    

    


    2.           The
      following is a list of the Health Plan’s Expanded Services:

    


    
      	
              a.  

            	
              Annual
                comprehensive oral exam, x-rays (one (1) per year), two (2) cleanings
                per
                year, silver amalgam fillings, one periodontic deep cleaning per
                year, two
                (2) periodontic scaling and root planing per
                year.

            


    

    


    
      	
              b.  

            	
              Up
                to $25 credit per household each month for selected over the counter
                drugs
                and/or health supplies.

            


    

    


    
      	
              c.  

            	
              Unlimited
                eye exams and eyeglasses, if medically
                necessary.

            


    

    


    
      	
              d.  

            	
              Free
                approved round trip transportation to medical
                appointments.

            


    

    


    
      	
              e.  

            	
              Circumcision
                up to one (1) year.

            


    

    


    
      
        AHCA
          Contract No. FA615, Amendment No. 2,
          Page 1 of  2 

      

      
        
        

        
          

        

      

      
        
        

      

       

    

    
      	
              5.

            	
              This
                Amendment shall have an effective date of September 1, 2007, or the
                date
                on which both parties
                execute the Amendment, whichever is later.

            	
               

            


    

    


    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 eight (8) 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,
                INC.

            	 	
              STATE
                OF FLORIDA, AGENCY FOR HEALTH CARE
                ADMINISTRATION

            
	
              SIGNED
                BY:  /s/  Todd S. Farha

            	 	
              SIGNED
                BY: /s/  Andrew Agwunobi

            
	
              NAME:  Todd
                S. Farha

            	 	
              NAME:  Andrew
                C. Agwunobi, M.D.

            
	
              TITLE:  CEO

            	 	
              TITLE:  Secretary

            
	
              DATE:  9/4/07

            	 	
              DATE: 9/6/07

            


    

     

    List
      of
      attachments included as part of this Amendment:


    
      
        	
                Specify
                  Type

              	
                Letter/
                  Number

              	
                Description

              
	
                Exhibit

              	
                II-B

              	
                Second
                  Revised Capitation Rates (1 Page)

              
	
                Exhibit

              	
                III-A

              	
                September
                  1, 2007- August 31, 2008 Medicaid Non-Reform HMO Capitation Rates
                  (5
                  Pages)

              


      

    

     

    REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK


    
      
          

          AHCA
            Contract No. FA615, Amendment No. 2, Page 2 of 
2 

          AHCA
            Form
            2100-0002 (Rev. NOV03)

        

        
        

      

      
        
        

        
          

        

      

      
        
        

        Wellcare
          of Florida, Inc. Medicaid HMO Contract 

          d/b/a
            Staywell Health Plan of Florida

        

      

    

     

    EXHIBIT
      II-B

    SECOND
      REVISED CAPITATION RATES

    


    
      	
               

            	
              A.

            	
              Table
                4 - General Capitation Rates plus Mental Health Rates plus
                Transportation:

            


    

    


    Area
      3 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Hernando

            	
              015016901

            
	
              Sumter

            	
              015016916

            


    

    


    Area
      5 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Pasco

            	
              015016903

            
	
              Pinellas

            	
              015016904

            


    

    


    Area
      6 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Hillsborough

            	
              015016902

            
	
              Manatee

            	
              015016912

            
	
              Polk

            	
              015016905

            


    

    


    Area
      7 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Orange

            	
              015016906

            
	
              Seminole

            	
              015016908

            
	
              Osceola

            	
              015016907

            
	
              Brevard

            	
              015016913

            


    

    


    Area
      8 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Lee

            	
              015016911

            
	
              Sarasota

            	
              015016914

            


    

    


    Area
      9 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Palm
                Beach

            	
              015016910

            
	
              St.
                Lucie

            	
              015016915

            


    

    


    Area
      10 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Broward

            	
              015016900

            


    

    


    Area
      11 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Miami-Dade

            	
              015016909

            


    

    


    


    REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK


    
      
        
          AHCA
            Contract No. FA615, Exhibit II-B, Page 1 of 1

          AHCA
            Form
            2100-0002 (Rev. NOV03)  

        

        
        

      

      
        
        

        
          

        

      

      
        
        

      

    


    
      	
              EXHIBIT
                III-A

            	 
	
              September
                1, 2007- August 31, 2008

            	 
	
              Medicaid
                Non-Reform HMO Capitation Rates

            	 
	
              By
                Area , Age and Eligibility Category 
                ESTIMATED
                  HEALTH PLAN RATES (NOT FOR USE UNLESS APPROVED BY CMS)

              

               

            	 
	 	 	 	 	 	 	 	 	 	 	
               

            	 	 
	
              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

            	
              1,131.99

            	
              202.30

            	
              105.58

            	
              66.22

            	
              135.19

            	
              72.29

            	
              265.45

            	
              167.89

            	
              347.47

            	
              10,081.87

            	
              1,458.88

            	
              435.95

            	
              201.26

            	
              222.08

            	
              716.10

            	
              703.88

            	
              271.50

            	
              138.14

            	
              112.37

            	
               

            
	
              02

            	
              1,131.99

            	
              202.30

            	
              105.58

            	
              66.22

            	
              135.19

            	
              72.29

            	
              265.45

            	
              167.89

            	
              347.47

            	
              10,081.87

            	
              1,458.88

            	
              435.95

            	
              201.26

            	
              222.08

            	
              716.10

            	
              703.88

            	
              271.50

            	
              138.14

            	
              112.37

            	
               

            
	
              03

            	
              1,296.42

            	
              233.58

            	
              122.13

            	
              77.48

            	
              156.47

            	
              84.50

            	
              308.68

            	
              196.24

            	
              408.68

            	
              11,326.29

            	
              1,656.79

            	
              495.12

            	
              233.33

            	
              256.55

            	
              826.59

            	
              816.63

            	
              273.34

            	
              129.66

            	
              105.80

            	
               

            
	
              04

            	
              1,128.87

            	
              203.75

            	
              106.78

            	
              67.92

            	
              136.68

            	
              74.01

            	
              269.88

            	
              171.79

            	
              358.59

            	
              10,675.98

            	
              1,563.58

            	
              467.86

            	
              220.87

            	
              242.36

            	
              781.86

            	
              772.10

            	
              330.41

            	
              133.72

            	
              109.08

            	
               

            
	
              05

            	
              1,260.50

            	
              227.66

            	
              119.09

            	
              75.94

            	
              152.59

            	
              82.61

            	
              301.42

            	
              191.81

            	
              400.30

            	
              11,774.49

            	
              1,721.01

            	
              514.94

            	
              241.96

            	
              266.53

            	
              857.42

            	
              846.21

            	
              230.22

            	
              127.48

            	
              104.72

            	
               

            
	
              06

            	
              1,111.64

            	
              201.87

            	
              106.04

            	
              68.10

            	
              135.60

            	
              74.02

            	
              269.07

            	
              171.81

            	
              360.32

            	
              10,832.05

            	
              1,590.31

            	
              475.95

            	
              225.91

            	
              247.84

            	
              799.09

            	
              790.01

            	
              284.19

            	
              124.63

            	
              101.81

            	 
	
              07

            	
              1,129.81

            	
              204.44

            	
              107.10

            	
              68.40

            	
              137.11

            	
              74.43

            	
              271.08

            	
              172.77

            	
              361.05

            	
              11,163.75

            	
              1,640.70

            	
              490.80

            	
              233.68

            	
              256.10

            	
              824.52

            	
              815.86

            	
              327.20

            	
              128.73

            	
              105.41

            	
               

            
	
              08

            	
              1,059.95

            	
              192.36

            	
              100.83

            	
              64.75

            	
              129.15

            	
              70.40

            	
              255.88

            	
              163.25

            	
              342.35

            	
              9,491.26

            	
              1,388.78

            	
              415.62

            	
              196.24

            	
              215.38

            	
              694.16

            	
              685.42

            	
              192.02

            	
              118.95

            	
              97.25

            	
               

            
	
              09

            	
              1,098.82

            	
              197.96

            	
              103.63

            	
              65.91

            	
              132.56

            	
              71.62

            	
              261.85

            	
              166.57

            	
              346.99

            	
              10,597.24

            	
              1,556.56

            	
              465.60

            	
              221.41

            	
              242.54

            	
              781.98

            	
              773.10

            	
              205.98

            	
              127.97

            	
              104.76

            	
               

            
	
              10

            	
              1,119.46

            	
              203.01

            	
              106.51

            	
              68.32

            	
              136.20

            	
              74.23

            	
              270.06

            	
              172.18

            	
              360.84

            	
              13,743.01

            	
              2,028.53

            	
              606.68

            	
              290.75

            	
              319.15

            	
              1,026.77

            	
              1,016.73

            	
              256.37

            	
              143.41

            	
              117.45

            	
               

            
	
              11

            	
              1,448.96

            	
              260.41

            	
              136.24

            	
              86.18

            	
              174.38

            	
              94.02

            	
              343.72

            	
              218.26

            	
              453.77

            	
              14,396.52

            	
              2,111.55

            	
              631.62

            	
              299.15

            	
              329.01

            	
              1,058.44

            	
              1,046.51

            	
              336.08

            	
              198.00

            	
              160.77

            	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              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

            	
              1,132.01

            	
              202.32

            	
              107.22

            	
              77.91

            	
              146.11

            	
              83.21

            	
              269.89

            	
              172.33

            	
              351.22

            	
              10,081.95

            	
              1,458.96

            	
              443.39

            	
              249.30

            	
              266.06

            	
              797.48

            	
              734.86

            	
              271.71

            	
              149.79

            	
              124.02

            	
               

            
	
              02

            	
              1,132.02

            	
              202.33

            	
              108.49

            	
              86.47

            	
              148.60

            	
              85.70

            	
              268.86

            	
              171.30

            	
              350.43

            	
              10,082.03

            	
              1,459.04

            	
              449.74

            	
              280.06

            	
              267.29

            	
              768.77

            	
              728.75

            	
              291.70

            	
              153.14

            	
              127.37

            	
               

            
	
              03

            	
              1,296.43

            	
              233.59

            	
              123.45

            	
              86.66

            	
              162.55

            	
              90.58

            	
              310.23

            	
              197.79

            	
              410.02

            	
              11,326.36

            	
              1,656.86

            	
              501.38

            	
              269.08

            	
              277.06

            	
              850.48

            	
              827.91

            	
              280.19

            	
              138.64

            	
              114.78

            	
               

            
	
              04

            	
              1,128.88

            	
              203.76

            	
              108.15

            	
              77.48

            	
              143.01

            	
              80.34

            	
              271.49

            	
              173.40

            	
              359.98

            	
              10,676.09

            	
              1,563.69

            	
              477.61

            	
              276.60

            	
              274.33

            	
              819.11

            	
              789.69

            	
              354.96

            	
              150.49

            	
              125.85

            	
               

            
	
              05

            	
              1,260.51

            	
              227.67

            	
              120.30

            	
              84.61

            	
              160.70

            	
              90.72

            	
              304.71

            	
              195.10

            	
              403.08

            	
              11,774.54

            	
              1,721.06

            	
              519.96

            	
              274.37

            	
              296.20

            	
              912.32

            	
              867.11

            	
              232.95

            	
              140.29

            	
              117.53

            	
               

            
	
              06

            	
              1,111.66

            	
              201.89

            	
              107.89

            	
              81.34

            	
              147.98

            	
              86.40

            	
              274.10

            	
              176.84

            	
              364.57

            	
              10,832.12

            	
              1,590.38

            	
              482.47

            	
              268.01

            	
              286.38

            	
              870.40

            	
              817.15

            	
              285.50

            	
              128.51

            	
              105.69

            	
               

            
	
              07

            	
              1,129.83

            	
              204.46

            	
              108.88

            	
              81.08

            	
              148.96

            	
              86.28

            	
              275.90

            	
              177.59

            	
              365.12

            	
              11,163.81

            	
              1,640.76

            	
              496.92

            	
              273.18

            	
              292.26

            	
              891.44

            	
              841.33

            	
              329.79

            	
              139.24

            	
              115.92

            	
               

            
	
              08

            	
              1,059.96

            	
              192.37

            	
              102.09

            	
              73.55

            	
              134.98

            	
              76.23

            	
              257.36

            	
              164.73

            	
              343.63

            	
              9,491.33

            	
              1,388.85

            	
              421.62

            	
              230.52

            	
              235.05

            	
              717.07

            	
              696.24

            	
              198.87

            	
              132.17

            	
              110.47

            	
               

            
	
              09

            	
              1,098.84

            	
              197.98

            	
              105.18

            	
              76.72

            	
              139.72

            	
              78.78

            	
              263.67

            	
              168.39

            	
              348.57

            	
              10,597.31

            	
              1,556.63

            	
              471.93

            	
              257.55

            	
              263.28

            	
              806.13

            	
              784.51

            	
              212.83

            	
              137.56

            	
              114.35

            	
               

            
	
              10

            	
              1,119.48

            	
              203.03

            	
              108.43

            	
              81.68

            	
              145.05

            	
              83.08

            	
              272.31

            	
              174.43

            	
              362.79

            	
              13,743.10

            	
              2,028.62

            	
              615.03

            	
              338.45

            	
              346.52

            	
              1,058.65

            	
              1,031.78

            	
              263.22

            	
              151.46

            	
              125.50

            	
               

            
	
              11

            	
              1,448.98

            	
              260.43

            	
              137.86

            	
              97.47

            	
              181.86

            	
              101.50

            	
              345.62

            	
              220.16

            	
              455.42

            	
              14,396.60

            	
              2,111.63

            	
              638.59

            	
              338.94

            	
              351.84

            	
              1,085.04

            	
              1,059.07

            	
              343.31

            	
              206.05

            	
              168.82

            	 


    

    


    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    
      	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              TABLE
                3  

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              General
                + MH + Dental 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

            	
              1,132.02

            	
              202.33

            	
              109.31

            	
              82.23

            	
              150.59

            	
              86.99

            	
              271.74

            	
              173.97

            	
              354.63

            	
              10,081.95

            	
              1,458.97

            	
              445.59

            	
              253.12

            	
              269.40

            	
              800.35

            	
              738.28

            	
              272.21

            	
              152.10

            	
              125.50

            	 
	
              02

            	
              1,132.03

            	
              202.34

            	
              110.58

            	
              90.79

            	
              153.08

            	
              89.48

            	
              270.71

            	
              172.94

            	
              353.84

            	
              10,082.03

            	
              1,459.05

            	
              451.94

            	
              283.88

            	
              270.63

            	
              771.64

            	
              732.17

            	
              292.20

            	
              155.45

            	
              128.85

            	 
	
              03

            	
              1,296.44

            	
              233.60

            	
              126.52

            	
              93.00

            	
              169.14

            	
              96.13

            	
              313.24

            	
              200.46

            	
              415.57

            	
              11,326.37

            	
              1,656.88

            	
              504.76

            	
              274.93

            	
              282.17

            	
              854.04

            	
              832.15

            	
              280.73

            	
              141.72

            	
              116.76

            	 
	
              04

            	
              1,128.89

            	
              203.77

            	
              110.20

            	
              81.71

            	
              147.39

            	
              84.03

            	
              274.30

            	
              175.89

            	
              365.17

            	
              10,676.09

            	
              1,563.70

            	
              479.82

            	
              280.43

            	
              277.68

            	
              822.42

            	
              793.64

            	
              356.97

            	
              153.57

            	
              127.83

            	 
	
              05

            	
              1,260.52

            	
              227.69

            	
              123.77

            	
              91.76

            	
              168.12

            	
              96.98

            	
              311.90

            	
              201.49

            	
              416.36

            	
              11,774.55

            	
              1,721.08

            	
              524.88

            	
              282.89

            	
              303.65

            	
              919.87

            	
              876.10

            	
              237.38

            	
              148.63

            	
              122.88

            	 
	
              06

            	
              1,111.67

            	
              201.90

            	
              110.53

            	
              86.79

            	
              153.63

            	
              91.17

            	
              277.72

            	
              180.05

            	
              371.26

            	
              10,832.13

            	
              1,590.40

            	
              485.64

            	
              273.51

            	
              291.19

            	
              874.82

            	
              822.42

            	
              287.34

            	
              133.29

            	
              108.76

            	 
	
              07

            	
              1,129.84

            	
              204.47

            	
              111.04

            	
              85.54

            	
              153.58

            	
              90.17

            	
              278.43

            	
              179.84

            	
              369.79

            	
              11,163.81

            	
              1,640.77

            	
              500.03

            	
              278.58

            	
              296.97

            	
              894.55

            	
              845.04

            	
              331.41

            	
              142.40

            	
              117.95

            	 
	
              08

            	
              1,059.97

            	
              192.38

            	
              105.11

            	
              79.80

            	
              141.46

            	
              81.69

            	
              260.37

            	
              167.40

            	
              349.19

            	
              9,491.34

            	
              1,388.87

            	
              424.74

            	
              235.93

            	
              239.77

            	
              720.67

            	
              700.54

            	
              200.35

            	
              135.32

            	
              112.48

            	 
	
              09

            	
              1,098.85

            	
              197.99

            	
              108.10

            	
              82.75

            	
              145.98

            	
              84.06

            	
              265.42

            	
              169.94

            	
              351.80

            	
              10,597.31

            	
              1,556.64

            	
              474.66

            	
              262.28

            	
              267.41

            	
              807.81

            	
              786.52

            	
              213.56

            	
              139.40

            	
              115.53

            	 
	
              10

            	
              1,119.49

            	
              203.04

            	
              111.29

            	
              87.56

            	
              151.15

            	
              88.23

            	
              274.13

            	
              176.05

            	
              366.16

            	
              13,743.11

            	
              2,028.64

            	
              618.77

            	
              344.93

            	
              352.19

            	
              1,060.76

            	
              1,034.30

            	
              265.27

            	
              154.03

            	
              127.15

            	 
	
              11

            	
              1,448.99

            	
              260.44

            	
              141.58

            	
              105.13

            	
              189.81

            	
              108.20

            	
              347.23

            	
              221.59

            	
              458.40

            	
              14,396.61

            	
              2,111.65

            	
              642.83

            	
              346.28

            	
              358.26

            	
              1,088.67

            	
              1,063.40

            	
              347.71

            	
              210.11

            	
              171.42

            	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              TABLE
                4   

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              General
                + MH + 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

            	
              1,137.56

            	
              203.71

            	
              108.08

            	
              78.43

            	
              148.03

            	
              84.47

            	
              272.98

            	
              174.71

            	
              354.40

            	
              10,125.36

            	
              1,486.99

            	
              449.03

            	
              251.78

            	
              272.18

            	
              817.47

            	
              751.37

            	
              278.48

            	
              163.52

            	
              132.78

            	
               

            
	
              02

            	
              1,137.57

            	
              203.72

            	
              109.35

            	
              86.99

            	
              150.52

            	
              86.96

            	
              271.95

            	
              173.68

            	
              353.61

            	
              10,125.44

            	
              1,487.07

            	
              455.38

            	
              282.54

            	
              273.41

            	
              788.76

            	
              745.26

            	
              298.47

            	
              166.87

            	
              136.13

            	
               

            
	
              03

            	
              1,303.13

            	
              235.26

            	
              124.49

            	
              87.29

            	
              164.87

            	
              92.09

            	
              313.95

            	
              200.67

            	
              413.86

            	
              11,381.17

            	
              1,692.25

            	
              508.50

            	
              272.20

            	
              284.79

            	
              875.73

            	
              848.76

            	
              288.81

            	
              158.48

            	
              127.44

            	
               

            
	
              04

            	
              1,133.91

            	
              205.01

            	
              108.93

            	
              77.95

            	
              144.75

            	
              81.48

            	
              274.28

            	
              175.56

            	
              362.87

            	
              10,720.46

            	
              1,592.34

            	
              483.38

            	
              279.13

            	
              280.59

            	
              839.55

            	
              806.56

            	
              361.93

            	
              166.27

            	
              135.91

            	
               

            
	
              05

            	
              1,264.71

            	
              228.72

            	
              120.95

            	
              85.01

            	
              162.15

            	
              91.67

            	
              307.04

            	
              196.90

            	
              405.49

            	
              11,809.84

            	
              1,743.85

            	
              524.54

            	
              276.38

            	
              301.18

            	
              928.58

            	
              880.53

            	
              238.83

            	
              154.32

            	
              126.48

            	
               

            
	
              06

            	
              1,115.71

            	
              202.90

            	
              108.52

            	
              81.72

            	
              149.38

            	
              87.31

            	
              276.35

            	
              178.58

            	
              366.89

            	
              10,866.95

            	
              1,612.87

            	
              487.00

            	
              270.00

            	
              291.30

            	
              886.44

            	
              830.40

            	
              290.82

            	
              140.11

            	
              113.09

            	
               

            
	
              07

            	
              1,133.77

            	
              205.44

            	
              109.49

            	
              81.45

            	
              150.32

            	
              87.17

            	
              278.09

            	
              179.28

            	
              367.38

            	
              11,201.13

            	
              1,664.85

            	
              501.77

            	
              275.30

            	
              297.53

            	
              908.63

            	
              855.51

            	
              335.43

            	
              151.37

            	
              123.67

            	
               

            
	
              08

            	
              1,065.54

            	
              193.77

            	
              102.95

            	
              74.07

            	
              136.91

            	
              77.49

            	
              260.46

            	
              167.12

            	
              346.83

            	
              9,532.67

            	
              1,415.54

            	
              427.00

            	
              232.88

            	
              240.88

            	
              736.11

            	
              711.96

            	
              204.95

            	
              146.97

            	
              119.92

            	
               

            
	
              09

            	
              1,104.22

            	
              199.32

            	
              106.02

            	
              77.23

            	
              141.58

            	
              79.99

            	
              266.66

            	
              170.70

            	
              351.65

            	
              10,640.50

            	
              1,584.51

            	
              477.55

            	
              260.02

            	
              269.38

            	
              826.01

            	
              800.93

            	
              219.75

            	
              153.37

            	
              124.43

            	
               

            
	
              10

            	
              1,123.27

            	
              203.97

            	
              109.01

            	
              82.04

            	
              146.35

            	
              83.94

            	
              274.42

            	
              176.05

            	
              364.96

            	
              13,782.23

            	
              2,053.89

            	
              620.11

            	
              340.69

            	
              352.05

            	
              1,076.67

            	
              1,046.66

            	
              270.52

            	
              169.12

            	
              136.76

            	
               

            
	
              11

            	
              1,452.24

            	
              261.24

            	
              138.36

            	
              97.78

            	
              182.98

            	
              102.24

            	
              347.43

            	
              221.56

            	
              457.29

            	
              14,425.98

            	
              2,130.60

            	
              642.40

            	
              340.62

            	
              355.99

            	
              1,098.57

            	
              1,070.25

            	
              348.23

            	
              218.56

            	
              176.80

            	 


    

    


    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    
      	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              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

            	
              1,137.54

            	
              203.69

            	
              106.44

            	
              66.74

            	
              137.11

            	
              73.55

            	
              268.54

            	
              170.27

            	
              350.65

            	
              10,125.28

            	
              1,486.91

            	
              441.59

            	
              203.74

            	
              228.20

            	
              736.09

            	
              720.39

            	
              278.27

            	
              151.87

            	
              121.13

            	
               

            
	
              02

            	
              1,137.54

            	
              203.69

            	
              106.44

            	
              66.74

            	
              137.11

            	
              73.55

            	
              268.54

            	
              170.27

            	
              350.65

            	
              10,125.28

            	
              1,486.91

            	
              441.59

            	
              203.74

            	
              228.20

            	
              736.09

            	
              720.39

            	
              278.27

            	
              151.87

            	
              121.13

            	 
	
              03

            	
              1,303.12

            	
              235.25

            	
              123.17

            	
              78.11

            	
              158.79

            	
              86.01

            	
              312.40

            	
              199.12

            	
              412.52

            	
              11,381.10

            	
              1,692.18

            	
              502.24

            	
              236.45

            	
              264.28

            	
              851.84

            	
              837.48

            	
              281.96

            	
              149.50

            	
              118.46

            	 
	
              04

            	
              1,133.90

            	
              205.00

            	
              107.56

            	
              68.39

            	
              138.42

            	
              75.15

            	
              272.67

            	
              173.95

            	
              361.48

            	
              10,720.35

            	
              1,592.23

            	
              473.63

            	
              223.40

            	
              248.62

            	
              802.30

            	
              788.97

            	
              337.38

            	
              149.50

            	
              119.14

            	 
	
              05

            	
              1,264.70

            	
              228.71

            	
              119.74

            	
              76.34

            	
              154.04

            	
              83.56

            	
              303.75

            	
              193.61

            	
              402.71

            	
              11,809.79

            	
              1,743.80

            	
              519.52

            	
              243.97

            	
              271.51

            	
              873.68

            	
              859.63

            	
              236.10

            	
              141.51

            	
              113.67

            	 
	
              06

            	
              1,115.69

            	
              202.88

            	
              106.67

            	
              68.48

            	
              137.00

            	
              74.93

            	
              271.32

            	
              173.55

            	
              362.64

            	
              10,866.88

            	
              1,612.80

            	
              480.48

            	
              227.90

            	
              252.76

            	
              815.13

            	
              803.26

            	
              289.51

            	
              136.23

            	
              109.21

            	 
	
              07

            	
              1,133.75

            	
              205.42

            	
              107.71

            	
              68.77

            	
              138.47

            	
              75.32

            	
              273.27

            	
              174.46

            	
              363.31

            	
              11,201.07

            	
              1,664.79

            	
              495.65

            	
              235.80

            	
              261.37

            	
              841.71

            	
              830.04

            	
              332.84

            	
              140.86

            	
              113.16

            	 
	
              08

            	
              1,065.53

            	
              193.76

            	
              101.69

            	
              65.27

            	
              131.08

            	
              71.66

            	
              258.98

            	
              165.64

            	
              345.55

            	
              9,532.60

            	
              1,415.47

            	
              421.00

            	
              198.60

            	
              221.21

            	
              713.20

            	
              701.14

            	
              198.10

            	
              133.75

            	
              106.70

            	 
	
              09

            	
              1,104.20

            	
              199.30

            	
              104.47

            	
              66.42

            	
              134.42

            	
              72.83

            	
              264.84

            	
              168.88

            	
              350.07

            	
              10,640.43

            	
              1,584.44

            	
              471.22

            	
              223.88

            	
              248.64

            	
              801.86

            	
              789.52

            	
              212.90

            	
              143.78

            	
              114.84

            	 
	
              10

            	
              1,123.25

            	
              203.95

            	
              107.09

            	
              68.68

            	
              137.50

            	
              75.09

            	
              272.17

            	
              173.80

            	
              363.01

            	
              13,782.14

            	
              2,053.80

            	
              611.76

            	
              292.99

            	
              324.68

            	
              1,044.79

            	
              1,031.61

            	
              263.67

            	
              161.07

            	
              128.71

            	 
	
              11

            	
              1,452.22

            	
              261.22

            	
              136.74

            	
              86.49

            	
              175.50

            	
              94.76

            	
              345.53

            	
              219.66

            	
              455.64

            	
              14,425.90

            	
              2,130.52

            	
              635.43

            	
              300.83

            	
              333.16

            	
              1,071.97

            	
              1,057.69

            	
              341.00

            	
              210.51

            	
              168.75

            	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              TABLE
                6    

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              General
                + Dental 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

            	
              1,132.00

            	
              202.31

            	
              107.67

            	
              70.54

            	
              139.67

            	
              76.07

            	
              267.30

            	
              169.53

            	
              350.88

            	
              10,081.87

            	
              1,458.89

            	
              438.15

            	
              205.08

            	
              225.42

            	
              718.97

            	
              707.30

            	
              272.00

            	
              140.45

            	
              113.85

            	
               

            
	
              02

            	
              1,132.00

            	
              202.31

            	
              107.67

            	
              70.54

            	
              139.67

            	
              76.07

            	
              267.30

            	
              169.53

            	
              350.88

            	
              10,081.87

            	
              1,458.89

            	
              438.15

            	
              205.08

            	
              225.42

            	
              718.97

            	
              707.30

            	
              272.00

            	
              140.45

            	
              113.85

            	 
	
              03

            	
              1,296.43

            	
              233.59

            	
              125.20

            	
              83.82

            	
              163.06

            	
              90.05

            	
              311.69

            	
              198.91

            	
              414.23

            	
              11,326.30

            	
              1,656.81

            	
              498.50

            	
              239.18

            	
              261.66

            	
              830.15

            	
              820.87

            	
              273.88

            	
              132.74

            	
              107.78

            	
               

            
	
              04

            	
              1,128.88

            	
              203.76

            	
              108.83

            	
              72.15

            	
              141.06

            	
              77.70

            	
              272.69

            	
              174.28

            	
              363.78

            	
              10,675.98

            	
              1,563.59

            	
              470.07

            	
              224.70

            	
              245.71

            	
              785.17

            	
              776.05

            	
              332.42

            	
              136.80

            	
              111.06

            	
               

            
	
              05

            	
              1,260.51

            	
              227.68

            	
              122.56

            	
              83.09

            	
              160.01

            	
              88.87

            	
              308.61

            	
              198.20

            	
              413.58

            	
              11,774.50

            	
              1,721.03

            	
              519.86

            	
              250.48

            	
              273.98

            	
              864.97

            	
              855.20

            	
              234.65

            	
              135.82

            	
              110.07

            	
               

            
	
              06

            	
              1,111.65

            	
              201.88

            	
              108.68

            	
              73.55

            	
              141.25

            	
              78.79

            	
              272.69

            	
              175.02

            	
              367.01

            	
              10,832.06

            	
              1,590.33

            	
              479.12

            	
              231.41

            	
              252.65

            	
              803.51

            	
              795.28

            	
              286.03

            	
              129.41

            	
              104.88

            	
               

            
	
              07

            	
              1,129.82

            	
              204.45

            	
              109.26

            	
              72.86

            	
              141.73

            	
              78.32

            	
              273.61

            	
              175.02

            	
              365.72

            	
              11,163.75

            	
              1,640.71

            	
              493.91

            	
              239.08

            	
              260.81

            	
              827.63

            	
              819.57

            	
              328.82

            	
              131.89

            	
              107.44

            	
               

            
	
              08

            	
              1,059.96

            	
              192.37

            	
              103.85

            	
              71.00

            	
              135.63

            	
              75.86

            	
              258.89

            	
              165.92

            	
              347.91

            	
              9,491.27

            	
              1,388.80

            	
              418.74

            	
              201.65

            	
              220.10

            	
              697.76

            	
              689.72

            	
              193.50

            	
              122.10

            	
              99.26

            	
               

            
	
              09

            	
              1,098.83

            	
              197.97

            	
              106.55

            	
              71.94

            	
              138.82

            	
              76.90

            	
              263.60

            	
              168.12

            	
              350.22

            	
              10,597.24

            	
              1,556.57

            	
              468.33

            	
              226.14

            	
              246.67

            	
              783.66

            	
              775.11

            	
              206.71

            	
              129.81

            	
              105.94

            	
               

            
	
              10

            	
              1,119.47

            	
              203.02

            	
              109.37

            	
              74.20

            	
              142.30

            	
              79.38

            	
              271.88

            	
              173.80

            	
              364.21

            	
              13,743.02

            	
              2,028.55

            	
              610.42

            	
              297.23

            	
              324.82

            	
              1,028.88

            	
              1,019.25

            	
              258.42

            	
              145.98

            	
              119.10

            	
               

            
	
              11

            	
              1,448.97

            	
              260.42

            	
              139.96

            	
              93.84

            	
              182.33

            	
              100.72

            	
              345.33

            	
              219.69

            	
              456.75

            	
              14,396.53

            	
              2,111.57

            	
              635.86

            	
              306.49

            	
              335.43

            	
              1,062.07

            	
              1,050.84

            	
              340.48

            	
              202.06

            	
              163.37

            	 


    

    


    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    
      	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              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)

            	
              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

            	
              1,137.55

            	
              203.70

            	
              108.53

            	
              71.06

            	
              141.59

            	
              77.33

            	
              270.39

            	
              171.91

            	
              354.06

            	
              10,125.28

            	
              1,486.92

            	
              443.79

            	
              207.56

            	
              231.54

            	
              738.96

            	
              723.81

            	
              278.77

            	
              154.18

            	
              122.61

            	
               

            
	
              02

            	
              1,137.55

            	
              203.70

            	
              108.53

            	
              71.06

            	
              141.59

            	
              77.33

            	
              270.39

            	
              171.91

            	
              354.06

            	
              10,125.28

            	
              1,486.92

            	
              443.79

            	
              207.56

            	
              231.54

            	
              738.96

            	
              723.81

            	
              278.77

            	
              154.18

            	
              122.61

            	
               

            
	
              03

            	
              1,303.13

            	
              235.26

            	
              126.24

            	
              84.45

            	
              165.38

            	
              91.56

            	
              315.41

            	
              201.79

            	
              418.07

            	
              11,381.11

            	
              1,692.20

            	
              505.62

            	
              242.30

            	
              269.39

            	
              855.40

            	
              841.72

            	
              282.50

            	
              152.58

            	
              120.44

            	
               

            
	
              04

            	
              1,133.91

            	
              205.01

            	
              109.61

            	
              72.62

            	
              142.80

            	
              78.84

            	
              275.48

            	
              176.44

            	
              366.67

            	
              10,720.35

            	
              1,592.24

            	
              475.84

            	
              227.23

            	
              251.97

            	
              805.61

            	
              792.92

            	
              339.39

            	
              152.58

            	
              121.12

            	
               

            
	
              05

            	
              1,264.71

            	
              228.73

            	
              123.21

            	
              83.49

            	
              161.46

            	
              89.82

            	
              310.94

            	
              200.00

            	
              415.99

            	
              11,809.80

            	
              1,743.82

            	
              524.44

            	
              252.49

            	
              278.96

            	
              881.23

            	
              868.62

            	
              240.53

            	
              149.85

            	
              119.02

            	
               

            
	
              06

            	
              1,115.70

            	
              202.89

            	
              109.31

            	
              73.93

            	
              142.65

            	
              79.70

            	
              274.94

            	
              176.76

            	
              369.33

            	
              10,866.89

            	
              1,612.82

            	
              483.65

            	
              233.40

            	
              257.57

            	
              819.55

            	
              808.53

            	
              291.35

            	
              141.01

            	
              112.28

            	
               

            
	
              07

            	
              1,133.76

            	
              205.43

            	
              109.87

            	
              73.23

            	
              143.09

            	
              79.21

            	
              275.80

            	
              176.71

            	
              367.98

            	
              11,201.07

            	
              1,664.80

            	
              498.76

            	
              241.20

            	
              266.08

            	
              844.82

            	
              833.75

            	
              334.46

            	
              144.02

            	
              115.19

            	
               

            
	
              08

            	
              1,065.54

            	
              193.77

            	
              104.71

            	
              71.52

            	
              137.56

            	
              77.12

            	
              261.99

            	
              168.31

            	
              351.11

            	
              9,532.61

            	
              1,415.49

            	
              424.12

            	
              204.01

            	
              225.93

            	
              716.80

            	
              705.44

            	
              199.58

            	
              136.90

            	
              108.71

            	
               

            
	
              09

            	
              1,104.21

            	
              199.31

            	
              107.39

            	
              72.45

            	
              140.68

            	
              78.11

            	
              266.59

            	
              170.43

            	
              353.30

            	
              10,640.43

            	
              1,584.45

            	
              473.95

            	
              228.61

            	
              252.77

            	
              803.54

            	
              791.53

            	
              213.63

            	
              145.62

            	
              116.02

            	
               

            
	
              10

            	
              1,123.26

            	
              203.96

            	
              109.95

            	
              74.56

            	
              143.60

            	
              80.24

            	
              273.99

            	
              175.42

            	
              366.38

            	
              13,782.15

            	
              2,053.82

            	
              615.50

            	
              299.47

            	
              330.35

            	
              1,046.90

            	
              1,034.13

            	
              265.72

            	
              163.64

            	
              130.36

            	
               

            
	
              11

            	
              1,452.23

            	
              261.23

            	
              140.46

            	
              94.15

            	
              183.45

            	
              101.46

            	
              347.14

            	
              221.09

            	
              458.62

            	
              14,425.91

            	
              2,130.54

            	
              639.67

            	
              308.17

            	
              339.58

            	
              1,075.60

            	
              1,062.02

            	
              345.40

            	
              214.57

            	
              171.35

            	 


    

    


    
      	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              TABLE
                8      

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              General
                + Mental Health + Dental + 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

            	
              1,137.57

            	
              203.72

            	
              110.17

            	
              82.75

            	
              152.51

            	
              88.25

            	
              274.83

            	
              176.35

            	
              357.81

            	
              10,125.36

            	
              1,487.00

            	
              451.23

            	
              255.60

            	
              275.52

            	
              820.34

            	
              754.79

            	
              278.98

            	
              165.83

            	
              134.26

            	
               

            
	
              02

            	
              1,137.58

            	
              203.73

            	
              111.44

            	
              91.31

            	
              155.00

            	
              90.74

            	
              273.80

            	
              175.32

            	
              357.02

            	
              10,125.44

            	
              1,487.08

            	
              457.58

            	
              286.36

            	
              276.75

            	
              791.63

            	
              748.68

            	
              298.97

            	
              169.18

            	
              137.61

            	
               

            
	
              03

            	
              1,303.14

            	
              235.27

            	
              127.56

            	
              93.63

            	
              171.46

            	
              97.64

            	
              316.96

            	
              203.34

            	
              419.41

            	
              11,381.18

            	
              1,692.27

            	
              511.88

            	
              278.05

            	
              289.90

            	
              879.29

            	
              853.00

            	
              289.35

            	
              161.56

            	
              129.42

            	
               

            
	
              04

            	
              1,133.92

            	
              205.02

            	
              110.98

            	
              82.18

            	
              149.13

            	
              85.17

            	
              277.09

            	
              178.05

            	
              368.06

            	
              10,720.46

            	
              1,592.35

            	
              485.59

            	
              282.96

            	
              283.94

            	
              842.86

            	
              810.51

            	
              363.94

            	
              169.35

            	
              137.89

            	
               

            
	
              05

            	
              1,264.72

            	
              228.74

            	
              124.42

            	
              92.16

            	
              169.57

            	
              97.93

            	
              314.23

            	
              203.29

            	
              418.77

            	
              11,809.85

            	
              1,743.87

            	
              529.46

            	
              284.90

            	
              308.63

            	
              936.13

            	
              889.52

            	
              243.26

            	
              162.66

            	
              131.83

            	
               

            
	
              06

            	
              1,115.72

            	
              202.91

            	
              111.16

            	
              87.17

            	
              155.03

            	
              92.08

            	
              279.97

            	
              181.79

            	
              373.58

            	
              10,866.96

            	
              1,612.89

            	
              490.17

            	
              275.50

            	
              296.11

            	
              890.86

            	
              835.67

            	
              292.66

            	
              144.89

            	
              116.16

            	
               

            
	
              07

            	
              1,133.78

            	
              205.45

            	
              111.65

            	
              85.91

            	
              154.94

            	
              91.06

            	
              280.62

            	
              181.53

            	
              372.05

            	
              11,201.13

            	
              1,664.86

            	
              504.88

            	
              280.70

            	
              302.24

            	
              911.74

            	
              859.22

            	
              337.05

            	
              154.53

            	
              125.70

            	
               

            
	
              08

            	
              1,065.55

            	
              193.78

            	
              105.97

            	
              80.32

            	
              143.39

            	
              82.95

            	
              263.47

            	
              169.79

            	
              352.39

            	
              9,532.68

            	
              1,415.56

            	
              430.12

            	
              238.29

            	
              245.60

            	
              739.71

            	
              716.26

            	
              206.43

            	
              150.12

            	
              121.93

            	
               

            
	
              09

            	
              1,104.23

            	
              199.33

            	
              108.94

            	
              83.26

            	
              147.84

            	
              85.27

            	
              268.41

            	
              172.25

            	
              354.88

            	
              10,640.50

            	
              1,584.52

            	
              480.28

            	
              264.75

            	
              273.51

            	
              827.69

            	
              802.94

            	
              220.48

            	
              155.21

            	
              125.61

            	
               

            
	
              10

            	
              1,123.28

            	
              203.98

            	
              111.87

            	
              87.92

            	
              152.45

            	
              89.09

            	
              276.24

            	
              177.67

            	
              368.33

            	
              13,782.24

            	
              2,053.91

            	
              623.85

            	
              347.17

            	
              357.72

            	
              1,078.78

            	
              1,049.18

            	
              272.57

            	
              171.69

            	
              138.41

            	
               

            
	
              11

            	
              1,452.25

            	
              261.25

            	
              142.08

            	
              105.44

            	
              190.93

            	
              108.94

            	
              349.04

            	
              222.99

            	
              460.27

            	
              14,425.99

            	
              2,130.62

            	
              646.64

            	
              347.96

            	
              362.41

            	
              1,102.20

            	
              1,074.58

            	
              352.63

            	
              222.62

            	
              179.40

            	
               

            


    

    


    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

    
      	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Area

            	 	
              Corresponding
                Counties

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Area
                1

            	 	
              Escambia,
                Okaloosa, Santa Rosa, 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, Hamiliton, Hernando,
                Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee,
                Union

            	 	 	 	 
	
              Area
                4

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

            	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Area
                5

            	 	
              Pasco,
                Pinellas

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Area
                6

            	 	
              Hardee,
                Highlands, Hillsborough, Manatee, Polk

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              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

            	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Area
                10

            	 	
              Broward

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Area
                11

            	 	
              Dade,
                Monroe

            	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
              Created
                on August 10, 2007