Document:

attestationh1216.htm

Back to Form 8-K

Exhibit 10.8

 

Medicare Advantage Attestation of Benefit Plan

 

HARMONY HEALTH PLAN OF ILLINOIS, INC.

 

H1216

 

I attest that I have examined the Plan Benefit Packages (PBPs) identified below and that the benefits identified in the PBPs are those that the above-stated organization will make available to eligible beneficiaries in the approved service area during program year 2011. I further attest that we have reviewed the bid pricing tools (BPTs) with the certifying actuary and have determined them to be consistent with the PBPs being attested to here.

 

I further attest that these benefits will be offered in accordance with all applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2010 and 2011, including but not limited to, the 2011 Call Letter, the 2011 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

 

	
Plan

ID

	
Segment

Id

	
Version

	
Plan Name

	
Plan

Type

	
Transaction 

Type

	
MA

Premium

	
Part D 

Premium

	
CMS Approval 

Date

	
Effective Date

	
001

	
0

	
7

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

	
003

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
19.10

	
09/03/2010

	
01/01/2011

	
005

	
0

	
6

	
WellCare Dividend (HMO)

	
HMO

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

 

H1216

 

  

  

  

	
Thomas Tran

	  	
9/2/2010 7:56:21 AM

	  	  	 	  
	  	  	  
	
Contracting Official Name

	
Date

	  	  	  
	  	  	  
	  	  	  
	
HARMONY HEALTH PLAN OF ILLINOIS, INC.

	
23 Public Square

	  	  	
Suite 400   

	  	  	Belleville, IL 62220	  
	  	  	 	  
	
Organization

	
Address

	  	  	  

H1216attestationh1264.htm

Back to Form 8-K

Exhibit 10.9

 

Medicare Advantage Attestation of Benefit Plan

 

WELLCARE OF TEXAS, INC.

 

H1264

 

I attest that I have examined the Plan Benefit Packages (PBPs) identified below and that the benefits identified in the PBPs are those that the above-stated organization will make available to eligible beneficiaries in the approved service area during program year 2011. I further attest that we have reviewed the bid pricing tools (BPTs) with the certifying actuary and have determined them to be consistent with the PBPs being attested to here.

 

I further attest that these benefits will be offered in accordance with all applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2010 and 2011, including but not limited to, the 2011 Call Letter, the 2011 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

	
 Plan

ID

	
Segment

ID

	
Version

	
Plan Name

	
Plan

Type

	
Transaction

Type

	
MA

Premium

	
Part D

Premium

	
CMS Approval Date

	
Effective

Date

	
004

	
0

	
5

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
1/1/2011

	
007

	
0

	
5

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
28.20

	
09/03/2010

	
1/1/2011

	
008

	
0

	
6

	
WellCare Dividend     (HMO)

	
HMO

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

	
014

	
0

	
6

	
WellCare Dividend (HMO)

	
HMO

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
1/1/2011

 

H1264

  

  

  

 

	
Thomas Tran

	  	
9/2/2010 7:56:42 AM

	  	  	 	  
	  	  	  
	
Contracting Official Name

	
Date

	  	  	  
	  	  	  
	  	  	  
	
WELLCARE OF TEXAS, INC.

	
8735 Henderson Rd

	  	  	
Ren 1

	  	  	Tampa, FL 33634	  
	  	  	 	  
	
Organization

	
Address

	  	  	  

H1264attestationh1416.htm

Back to Form 8-K

Exhibit 10.10

Medicare Advantage Attestation of Benefit Plan

 

HARMONY HEALTH PLAN OF ILLINOIS, INC.

 

H1416

 

I attest that I have examined the Plan Benefit Packages (PBPs) identified below and that the benefits identified in the PBPs are those that the above-stated organization will make available to eligible beneficiaries in the approved service area during program year 2011. I further attest that we have reviewed the bid pricing tools (BPTs) with the certifying actuary and have determined them to be consistent with the PBPs being attested to here.

 

I further attest that these benefits will be offered in accordance with all applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2010 and 2011, including but not limited to, the 2011 Call Letter, the 2011 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

	
Plan

ID

	
Segment

ID

	
Version

	
Plan Name

	
Plan

Type

	
Transaction  

Type

	
MA

Premium

	
Part D

Premium

	
CMS 

Approval 

Date

	
Effective

Date

	
007

	
0

	
5

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
15.10

	
09/03/2010

	
01/01/2011

	
009

	
0

	
5

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

	
018

	
0

	
6

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

	
019

	
0

	
5

	
WellCare Rx (HMO)

	
HMO

	
Renewal

	
0.00

	
28.70

	
09/03/2010

	
01/01/2011

	
022

	
0

	
6

	
WellCare Dividend (HMO)

	
HMO

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

 

H1416

  

  

  

	
Thomas Tran

	  	
9/2/2010 7:57:07 AM

	  	  	 	  
	  	  	  
	
Contracting Official Name

	
Date

	  	  	  
	  	  	  
	  	  	  
	
 

	
125 SOUTH WACKER DRIVE SUITE 2600

	 
HARMONY HEALTH PLAN OF ILLINOIS, INC.

	  	
CHICAGO, IL 606064402

	  	  	 	  
	  	  	 	  
	
Organization

	
Address

	  	  	  

H1416attestationh1657.htm

Back to Form 8-K

Exhibit 10.11

 

Medicare Advantage Attestation of Benefit Plan

 

HARMONY HEALTH PLANS OF ILLINOIS, INC.

 

H1657

 

I attest that I have examined the Plan Benefit Packages (PBPs) identified below and that the benefits identified in the PBPs are those that the above-stated organization will make available to eligible beneficiaries in the approved service area during program year 2011.1 further attest that we have reviewed the bid pricing tools (BPTs) with the certifying actuary and have determined them to be consistent with the PBPs being attested to here.

 

I further attest that these benefits will be offered in accordance with all applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2010 and 2011, including but not limited to, the 2011 Call Letter, the 2011 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

 

	
Plan

ID

	
Segment

ID

	
Version

	
Plan Name

	
Plan

Type

	
Transaction

Type

	
MA

Premium

	
Part D

Premium

	
  CMS

Approval

Date

	
Effective

Date

	
002

	
0

	
8

	
WellCare Value (HMO 

-POS)

	
HMOPOS

	
Renewal

	
0.00

	
0

	
9/3/2010

	
01/01/2011

 

H1657

  

  

  

	
Thomas Tran

	  	
9/2/2010 7:57:32 AM

	  	  	 	  
	  	  	  
	
Contracting Official Name

	
Date

	  	  	  
	  	  	  
	  	  	  
	
 

	
8735 Henderson Rd., Ren 2

	 
HARMONY HEALTH PLANS OF ILLINOIS, INC.

	  	
Tampa, FL 33634

	  	  	 	  
	  	  	 	  
	
Organization

	
Address

	  	  	  

H1657attestationh1903.htm

Back to Form 8-K

Exhibit 10.12

 

Medicare Advantage Attestation of Benefit Plan

 

WELLCARE OF LOUISIANA, INC.

 

H1903

 

I attest that I have examined the Plan Benefit Packages (PBPs) identified below and that the benefits identified in the PBPs are those that the above-stated organization will make available to eligible beneficiaries in the approved service area during program year 2011. I further attest that we have reviewed the bid pricing tools (BPTs) with the certifying actuary and have determined them to be consistent with the PBPs being attested to here.

 

I further attest that these benefits will be offered in accordance with all applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2010 and 2011, including but not limited to, the 2011 Call Letter, the 2011 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

	
Plan

ID

	
Segment

Id

	
Version

	
Plan Name

	
Plan

Type

	
Transaction 

Type

	
MA

Premium

	
Part D 

Premium

	
CMS Approval Date

	
Effective 

Date

	
005

	
0

	
4

	
WellCare Advance (HMO)

	
HMO

	
Renewal

	
0.00

	
N/A

	
09/03/2010

	
01/01/2011

	
011

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
32.60

	
09/03/2010

	
01/01/2011

	
022

	
0

	
5

	
WellCare Value (HMO-POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

	
024

	
0

	
7

	
WellCare Dividend (HMO-POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
09/03/2010

	
01/01/2011

 

H1903

  

  

  

	
Thomas Tran

	  	
9/2/2010 7:57:53 AM

	  	  	 	  
	  	  	  
	
Contracting Official Name

	
Date

	  	  	  
	  	  	  
	  	  	  
	
 

	
8735 Henderson Rd

	  	  	
Ren 1

	
WELLCARE OF LOUISIANA, INC.

	  	
Tampa, FL 33634

 

	  
	  	  	 	  
	
Organization

	
Address

	  	  	  

H1903

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