Document:

EX-10.1

AHCA CONTRACT NO. FA522

AMENDMENT NO. 7

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE
ADMINISTRATION, hereinafter referred to as the “Agency” and WELLCARE HMO, INC., d/b/a STAYWELL
HEALTHE PLAN OF FLORIDA, hereinafter referred to as the “Vendor” is hereby amended as follows:

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

To pay for contracted services according to the conditions of Attachment I in an amount not to
exceed $657,268,872.00 (an increase of $1,413,622.00), subject to the availability of funds.

	 	2.	 	Attachment I, section 90.0, Payment and Authorized enrollment Levels, Table 2 is hereby
amended to now read as follows:

Table 2.

Area wide Age-banded Capitation Rates for All Agency Areas of the State other than Areas 3, 5,6, 7
(Orange, Osceola, and Seminole counties) and 8.

Area 07 General Rates Plan  —  015016913 (BREVARD)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	337.19	 	 	 	75.53	 	 	 	47.77	 	 	 	52.81	 	 	 	108.40	 	 	 	134.29	 	 	 	204.16	 	 	 	286.57	 	 	 	286.57	 
	SSI/No Medicare
	 	 	3217.89	 	 	 	389.79	 	 	 	203.90	 	 	 	213.35	 	 	 	213.35	 	 	 	610.58	 	 	 	610.58	 	 	 	589.11	 	 	 	589.11	 
	SSI/Part B
	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 
	SSI/Part A & B
	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	198.62	 

Area 09 General Rates Plan  —  015016910 (PALM BEACH)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	316.78	 	 	 	70.74	 	 	 	44.52	 	 	 	49.17	 	 	 	101.48	 	 	 	125.24	 	 	 	190.60	 	 	 	266.97	 	 	 	266.97	 
	SSI/No Medicare
	 	 	3344.05	 	 	 	405.22	 	 	 	211.12	 	 	 	221.15	 	 	 	221.15	 	 	 	633.22	 	 	 	633.22	 	 	 	610.93	 	 	 	610.93	 
	SSI/Part B
	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 
	SSI/Part A & B
	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	224.19	 

Area 10 General Rates Plan  —  015016900 (BROWARD)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	328.74	 	 	 	73.77	 	 	 	46.68	 	 	 	51.61	 	 	 	105.94	 	 	 	131.31	 	 	 	199.49	 	 	 	280.33	 	 	 	280.33	 
	SSI/No Medicare
	 	 	4151.82	 	 	 	503.54	 	 	 	263.75	 	 	 	275.32	 	 	 	275.32	 	 	 	788.23	 	 	 	788.23	 	 	 	761.08	 	 	 	761.08	 
	SSI/Part B
	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 
	SSI/Part A & B
	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 

Area 11 General Rates Plan  —  015016909 (DADE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	409.89	 	 	 	91.51	 	 	 	57.28	 	 	 	63.45	 	 	 	131.27	 	 	 	161.21	 	 	 	245.94	 	 	 	343.29	 	 	 	343.29	 
	SSI/No Medicare
	 	 	4561.77	 	 	 	556.46	 	 	 	288.69	 	 	 	302.80	 	 	 	302.80	 	 	 	869.67	 	 	 	869.67	 	 	 	836.38	 	 	 	836.38	 
	SSI/Part B
	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 
	SSI/Part A & B
	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	297.22	 

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

Table 3

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

Area 03 General Rates plus Mental Health Plan  —  015016901 (HERNANDO)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	350.93	 	 	 	79.08	 	 	 	55.35	 	 	 	58.65	 	 	 	116.64	 	 	 	139.68	 	 	 	212.08	 	 	 	294.58	 	 	 	294.58	 
	SSI/No Medicare
	 	 	3231.66	 	 	 	408.26	 	 	 	247.79	 	 	 	236.33	 	 	 	236.33	 	 	 	626.37	 	 	 	626.37	 	 	 	591.60	 	 	 	591.60	 
	SSI/Part B
	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 
	SSI/Part A & B
	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	209.16	 

Area 05 General Rates plus Mental Health Plan  —  015016903 (PASCO) 015016904 (PINELLAS)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	345.77	 	 	 	79.28	 	 	 	51.94	 	 	 	57.32	 	 	 	114.37	 	 	 	139.01	 	 	 	210.44	 	 	 	291.84	 	 	 	291.84	 
	SSI/No Medicare
	 	 	3265.63	 	 	 	429.24	 	 	 	240.86	 	 	 	235.59	 	 	 	235.59	 	 	 	628.37	 	 	 	628.37	 	 	 	594.95	 	 	 	594.95	 
	SSI/Part B
	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 
	SSI/Part A & B
	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	225.77	 

Area 06 General Rates plus Mental Health Plan  —  015016902 (HILLSBOROUGH) 015016905 (POLK)
015016912 (MANATEE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	330.07	 	 	 	75.91	 	 	 	61.92	 	 	 	67.67	 	 	 	122.23	 	 	 	135.83	 	 	 	204.29	 	 	 	282.98	 	 	 	282.98	 
	SSI/No Medicare
	 	 	3017.05	 	 	 	371.69	 	 	 	265.72	 	 	 	243.82	 	 	 	243.82	 	 	 	647.81	 	 	 	647.81	 	 	 	587.26	 	 	 	587.26	 
	SSI/Part B
	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 
	SSI/Part A & B
	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	202.64	 

Area 07 General Rates plus Mental Health Plan  —  015016906 (ORANGE) 015016907 (OSCEOLA)
015016908 (SEMINOLE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	337.20	 	 	 	76.92	 	 	 	58.07	 	 	 	59.10	 	 	 	114.69	 	 	 	136.45	 	 	 	206.32	 	 	 	287.87	 	 	 	287.87	 
	SSI/No Medicare
	 	 	3217.90	 	 	 	406.84	 	 	 	260.45	 	 	 	239.73	 	 	 	239.73	 	 	 	628.24	 	 	 	628.24	 	 	 	594.96	 	 	 	594.96	 
	SSI/Part B
	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 
	SSI/Part A & B
	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	208.25	 

Area 08 General Rates plus Mental Health Plan  —  015016911 (LEE) 015016914 (SARASOTA)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	296.69	 	 	 	67.77	 	 	 	46.25	 	 	 	49.88	 	 	 	98.88	 	 	 	119.48	 	 	 	180.88	 	 	 	251.72	 	 	 	251.72	 
	SSI/No Medicare
	 	 	3079.31	 	 	 	393.43	 	 	 	223.95	 	 	 	221.50	 	 	 	221.50	 	 	 	594.93	 	 	 	594.93	 	 	 	563.76	 	 	 	563.76	 
	SSI/Part B
	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 
	SSI/Part A & B
	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	206.49	 

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

Notwithstanding the payment amounts which may be computed with the above rate table, the sum of
total capitation payments under this contract shall not exceed the total contract amount of
$657,268,872.00 (an increase of $1,413,622.00), expressed on page seven of this contract.

	 	5.	 	This amendment shall begin on June 1, 2005, or the date on which the amendment has been
signed by both parties, 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 3 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.

	 	 	 
	WELLCARE HMO, INC.	 	STATE OF FLORIDA, AGENCY FOR
	D/B/A STAYWELL HEALTH	 	HEALTH CARE ADMINISTRATION
	PLAN OF FLORIDA	 	 
	SIGNED

BY:      

NAME: Todd S. Farha

	 	SIGNED

BY:      

NAME: Alan Levine
	 

	 	 
	TITLE: President and CEO

	 	TITLE: Secretary
	 

	 	 
	DATE:      

	 	DATE:      

THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLYEX-10.2

AHCA CONTRACT NO. FA521

AMENDMENT NO. 6

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” is hereby amended as follows:

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

To pay for contracted services according to the conditions of Attachment I in an amount not to
exceed $820,932,336.00 (an increase of $4,970,587.00), subject to the availability of funds.

	 	2.	 	Attachment I, Section 90.0, Payment and Authorized enrollment Levels, Table 2 is hereby
amended to now read as follows:

Table 2.

Area wide Age-banded Capitation Rates for All Agency Areas of the State.

Area 04 General Rates Plan  —  015019335 (VOLUSIA)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	316.95	 	 	 	71.10	 	 	 	44.92	 	 	 	49.61	 	 	 	101.93	 	 	 	126.35	 	 	 	191.96	 	 	 	269.58	 	 	 	269.58	 
	SSI/No Medicare
	 	 	3103.82	 	 	 	374.05	 	 	 	193.41	 	 	 	202.51	 	 	 	202.51	 	 	 	580.16	 	 	 	580.16	 	 	 	559.62	 	 	 	559.62	 
	SSI/Part B
	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 	 	 	273.15	 
	SSI/Part A & B
	 	 	292.54	 	 	 	292.54	 	 	 	292.54	 	 	 	292.54	 	 	 	292.54	 	 	 	292.54	 	 	 	292.54	 	 	 	292.54	 	 	 	204.72	 

Area 07 General Rates Plan  —  015019308 (BREVARD)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	337.19	 	 	 	75.53	 	 	 	47.77	 	 	 	52.81	 	 	 	108.40	 	 	 	134.29	 	 	 	204.16	 	 	 	286.57	 	 	 	286.57	 
	SSI/No Medicare
	 	 	3217.89	 	 	 	389.79	 	 	 	203.90	 	 	 	213.35	 	 	 	213.35	 	 	 	610.58	 	 	 	610.58	 	 	 	589.11	 	 	 	589.11	 
	SSI/Part B
	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 	 	 	265.77	 
	SSI/Part A & B
	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	283.96	 	 	 	198.62	 

Area 09 General Rates Plan  —  015019324 (MARTIN) 015019339 (PALM BEACH)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	316.78	 	 	 	70.74	 	 	 	44.52	 	 	 	49.17	 	 	 	101.48	 	 	 	125.24	 	 	 	190.60	 	 	 	266.97	 	 	 	266.97	 
	SSI/No Medicare
	 	 	3344.05	 	 	 	405.22	 	 	 	211.12	 	 	 	221.15	 	 	 	221.15	 	 	 	633.22	 	 	 	633.22	 	 	 	610.93	 	 	 	610.93	 
	SSI/Part B
	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 	 	 	267.20	 
	SSI/Part A & B
	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	320.32	 	 	 	224.19	 

Area 10 General Rates Plan  —  015019337 (BROWARD)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	328.74	 	 	 	73.77	 	 	 	46.68	 	 	 	51.61	 	 	 	105.94	 	 	 	131.31	 	 	 	199.49	 	 	 	280.33	 	 	 	280.33	 
	SSI/No Medicare
	 	 	4151.82	 	 	 	503.54	 	 	 	263.75	 	 	 	275.32	 	 	 	275.32	 	 	 	788.23	 	 	 	788.23	 	 	 	761.08	 	 	 	761.08	 
	SSI/Part B
	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 	 	 	287.04	 
	SSI/Part A & B
	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	351.55	 	 	 	245.95	 

REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK

1

Area 11 General Rates plus Transportation Plan  —  015019338 (DADE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	409.89	 	 	 	91.51	 	 	 	57.28	 	 	 	63.45	 	 	 	131.27	 	 	 	161.21	 	 	 	245.94	 	 	 	343.29	 	 	 	343.29	 
	SSI/No Medicare
	 	 	4561.77	 	 	 	556.46	 	 	 	288.69	 	 	 	302.80	 	 	 	302.80	 	 	 	869.67	 	 	 	869.67	 	 	 	836.38	 	 	 	836.38	 
	SSI/Part B
	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 	 	 	453.72	 
	SSI/Part A & B
	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	429.61	 	 	 	297.22	 

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

Table 3

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

Area 01 General Rates plus Mental Health Plan  —  015019314 (ESCAMBIA) 015019331 (SANTA ROSA)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	308.58	 	 	 	69.00	 	 	 	49.05	 	 	 	52.61	 	 	 	103.52	 	 	 	121.46	 	 	 	184.66	 	 	 	257.30	 	 	 	257.30	 
	SSI/No Medicare
	 	 	3048.46	 	 	 	371.81	 	 	 	243.40	 	 	 	238.17	 	 	 	238.17	 	 	 	607.82	 	 	 	607.82	 	 	 	569.75	 	 	 	569.75	 
	SSI/Part B
	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 	 	 	330.18	 
	SSI/Part A & B
	 	 	328.66	 	 	 	328.66	 	 	 	328.66	 	 	 	328.66	 	 	 	328.66	 	 	 	328.66	 	 	 	328.66	 	 	 	328.66	 	 	 	324.66	 

Area 02 General Rates plus Mental Health Plan  —  015019315 (GADSDEN) 015019318 (JEFFERSON)
015019320 (LEON)

015019322 (MADISON) 015019336 (WAKULLA) 015019342 (LIBERTY) 015019340 (CALHOUN)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	308.58	 	 	 	69.19	 	 	 	60.98	 	 	 	55.90	 	 	 	106.81	 	 	 	120.89	 	 	 	184.09	 	 	 	253.06	 	 	 	253.06	 
	SSI/No Medicare
	 	 	3048.46	 	 	 	372.48	 	 	 	300.12	 	 	 	242.56	 	 	 	242.56	 	 	 	591.95	 	 	 	591.95	 	 	 	562.93	 	 	 	562.93	 
	SSI/Part B
	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 	 	 	334.32	 
	SSI/Part A & B
	 	 	327.20	 	 	 	327.20	 	 	 	327.20	 	 	 	327.20	 	 	 	327.20	 	 	 	327.20	 	 	 	327.20	 	 	 	327.20	 	 	 	233.20	 

Area 03 General Rates plus Mental Health Plan  —  015019309 (CITRUS) 015019319 (LAKE) 015019323
(MARION)

015019329 (PUTNAM)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	350.93	 	 	 	79.08	 	 	 	55.35	 	 	 	58.65	 	 	 	116.64	 	 	 	139.68	 	 	 	212.08	 	 	 	294.58	 	 	 	294.58	 
	SSI/No Medicare
	 	 	3231.66	 	 	 	408.26	 	 	 	247.79	 	 	 	236.33	 	 	 	236.33	 	 	 	626.37	 	 	 	626.37	 	 	 	591.60	 	 	 	591.60	 
	SSI/Part B
	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 	 	 	302.32	 
	SSI/Part A & B
	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	295.89	 	 	 	209.16	 

Area 04 General Rates plus Mental Health Plan  —  015019313 (DUVAL)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	316.96	 	 	 	72.59	 	 	 	53.19	 	 	 	54.51	 	 	 	106.83	 	 	 	128.19	 	 	 	193.80	 	 	 	270.44	 	 	 	270.44	 
	SSI/No Medicare
	 	 	3103.85	 	 	 	383.49	 	 	 	248.61	 	 	 	232.79	 	 	 	232.79	 	 	 	607.27	 	 	 	607.27	 	 	 	571.05	 	 	 	571.05	 
	SSI/Part B
	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 	 	 	277.60	 
	SSI/Part A & B
	 	 	312.33	 	 	 	312.33	 	 	 	312.33	 	 	 	312.33	 	 	 	312.33	 	 	 	312.33	 	 	 	312.33	 	 	 	312.33	 	 	 	224.51	 

Area 05 General Rates plus Mental Health Plan  —  015019302 (PASCO) 015019303 (PINELLAS)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	345.77	 	 	 	79.28	 	 	 	51.94	 	 	 	57.32	 	 	 	114.37	 	 	 	139.01	 	 	 	210.44	 	 	 	291.84	 	 	 	291.84	 
	SSI/No Medicare
	 	 	3265.63	 	 	 	429.24	 	 	 	240.86	 	 	 	235.59	 	 	 	235.59	 	 	 	628.37	 	 	 	628.37	 	 	 	594.95	 	 	 	594.95	 
	SSI/Part B
	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 	 	 	266.87	 
	SSI/Part A & B
	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	318.72	 	 	 	225.77	 

2

Area 06 General Rates plus Mental Health Plan  —  015019300 (HILLSBOROUGH) 015019301 (MANATEE)
015019304 (POLK)

015019317 (HIGHLANDS)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	330.07	 	 	 	75.91	 	 	 	61.92	 	 	 	67.67	 	 	 	122.23	 	 	 	135.83	 	 	 	204.29	 	 	 	282.98	 	 	 	282.98	 
	SSI/No Medicare
	 	 	3017.05	 	 	 	371.69	 	 	 	265.72	 	 	 	243.82	 	 	 	243.82	 	 	 	647.81	 	 	 	647.81	 	 	 	587.26	 	 	 	587.26	 
	SSI/Part B
	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 	 	 	242.29	 
	SSI/Part A & B
	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	288.09	 	 	 	202.64	 

Area 07 General Rates plus Mental Health Plan  —  015019327 (ORANGE) 015019328 (OSCEOLA)
015019333 (SEMINOLE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	337.20	 	 	 	76.92	 	 	 	58.07	 	 	 	59.10	 	 	 	114.69	 	 	 	136.45	 	 	 	206.32	 	 	 	287.87	 	 	 	287.87	 
	SSI/No Medicare
	 	 	3217.90	 	 	 	406.84	 	 	 	260.45	 	 	 	239.73	 	 	 	239.73	 	 	 	628.24	 	 	 	628.24	 	 	 	594.96	 	 	 	594.96	 
	SSI/Part B
	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 	 	 	266.03	 
	SSI/Part A & B
	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	293.59	 	 	 	208.25	 

Area 08 General Rates plus Mental Health Plan  —  015019332 (SARASOTA)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	<1 year	 	 	1-5	 	 	 	6-13	 	 	14-20 Male	 	14-20 Female	 	21-54 Male	 	21-54 Female	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	296.69	 	 	 	67.77	 	 	 	46.25	 	 	 	49.88	 	 	 	98.88	 	 	 	119.48	 	 	 	180.88	 	 	 	251.72	 	 	 	251.72	 
	SSI/No Medicare
	 	 	3079.31	 	 	 	393.43	 	 	 	223.95	 	 	 	221.50	 	 	 	221.50	 	 	 	594.93	 	 	 	594.93	 	 	 	563.76	 	 	 	563.76	 
	SSI/Part B
	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 	 	 	243.57	 
	SSI/Part A & B
	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	292.10	 	 	 	206.49	 

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

Notwithstanding the payment amounts which may be computed with the above rate table, the sum of
total capitation payments under this contract shall not exceed the total contract amount of
$820,901,720.00 (an increase of $4,939,971.00) expressed on page seven of this contract.

	 	5.	 	This amendment shall begin on June 1, 2005, or the date on which the amendment has been
signed by both parties, 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 4 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.

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3

	 	 	 
	HEALTHEASE OF FLORIDA, INC.	 	STATE OF FLORIDA, AGENCY FOR
	 	 	HEALTH CARE ADMINISTRATION
	SIGNED

BY:      

NAME: Todd S. Farha

	 	SIGNED

BY:      

NAME: Alan Levine
	 

	 	 
	TITLE: President and CEO

	 	TITLE: Secretary
	 

	 	 
	DATE:      

	 	DATE:      

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4

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