fa619amend1.htm


    
      

    

    Back
      to Form 8-K

    Exhibit
      10.1


    AHCA
      CONTRACT NO. FA619

    AMENDMENT
      NO. 1

    


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

    


    
      	
              1.

            	
              All
                references in the Contract to the Vendor’s company name are hereby changed
                from HealthEase of Florida, Inc. and/or HealthEase Health Plan of
                Florida,
                Inc. to HealthEase of Florida, Inc..  The Vendor’s contact
                information, including names, addresses and telephone numbers and
                the
                Vendor’s FEID number remain
                unchanged.

            


    

    


    
      	
              2.

            	
              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

            


    

    
      	
               

            	
              Healthease
                of Florida, Inc.

            


      	 	8735
              Henderson Road


      	 	Tampa,
              FL  33614-3988


      	 	(813)
              865-5038


    

     

    
      	
              3.

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

            


    

    


    
      	
              4.

            	
              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.

            


    

    


    
      	
              5.

            	
              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. FA619, Amendment No. 1, Page 1 of 2
          AHCA
            Form
            2100-0002 (Rev. NOV03)    

        

        
        

      

      
        
        

        
          

        

      

      
        
        

        
          HealthEase
            of Florida, Inc. Medicaid HMO
            Contract       

        

      

    


    6.           This
      Amendment shall have an effective date of September 1, 2007, or the date on
      which bothparties 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 nine (9) page Amendment (which includes all attachments hereto)
      to be executed by their officials thereunto duly authorized.

    


    


    
      	
              HEALTHEASE
                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-A

            	
              Revised
                Capitation Rates (2 Pages)

            
	
              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. FA619, Amendment No. 1, Page 2 of 2
          AHCA
            Form
            2100-0002 (Rev. NOV03)

        

        
        

      

      
        
        

        
          

        

      

      
        
        

        HealthEase
          of Florida, Inc. Medicaid HMO Contract d/b/a
          HealthEase           

      

    

    


    EXHIBIT
      II-A

    REVISED
      CAPITATION RATES

    


    A.           Table
      2 - General Capitation Rates plus Mental Health Rates:

    


    Area
      2 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Liberty

            	
              015019342

            
	
              Jefferson

            	
              015019318

            
	
              Madison

            	
              015019322

            
	
              Wakulla

            	
              015019336

            


    

    


    B.           Table
      4 - General Capitation Rates plus Mental Health Rates and Transportation
      Rates:

    


    Area
      1 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Escambia

            	
              015019314

            
	
              Santa
                Rosa

            	
              015019331

            


    

    


    Area
      2 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Calhoun

            	
              015019340

            
	
              Gadsden

            	
              015019315

            
	
              Leon

            	
              015019320

            


    

    


    Area
      3 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Citrus

            	
              015019309

            
	
              Lake

            	
              015019319

            
	
              Marion

            	
              015019323

            
	
              Putnam

            	
              015019329

            


    

    


    Area
      4 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Duval

            	
              015019313

            
	
              Volusia

            	
              015019335

            


    

    


    Area
      5 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Pasco

            	
              015019302

            
	
              Pinellas

            	
              015019303

            


    

    


    Area
      6 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Highlands

            	
              015019317

            
	
              Hillsborough

            	
              015019300

            
	
              Manatee

            	
              015019301

            
	
              Polk

            	
              015019304

            


    

    



    
      
        AHCA
          Contract No. FA619, Exhibit II-A, Page 1 of 2 

          AHCA
            Form
            2100-0002 (Rev. NOV03)

        

        
        

      

      
        
        

        
          

        

      

      
        
        

        HealthEase
          of Florida, Inc. Medicaid HMO Contract d/b/a HealthEase  

      

    


    


    Area
      7 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Brevard

            	
              015019308

            
	
              Orange

            	
              015019327

            
	
              Osceola

            	
              015019328

            
	
              Seminole

            	
              015019333

            


    

    


    Area
      8 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Sarasota

            	
              015019332

            


    

    


    Area
      9 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Martin

            	
              015019324

            
	
              Palm
                Beach

            	
              015019339

            


    

    


    Area
      10 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Broward

            	
              015019337

            


    

    


    Area
      11 Counties:

    
      	
              County

            	
              Provider
                Number

            
	
              Miami-Dade

            	
              015019338

            


    

    


    REMAINDER
      OF PAGE INTENTIONALLY LEFT BLANK


    
      
        
          AHCA
            Contract No. FA619, Exhibit II-A, Page 2 of
            2 

          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