Document:

Ex103_2015-H1032

Back to Form 8-K
Exhibit 10.3

CONTRACT WITH ELIGIBLE MEDICARE ADVANTAGE (MA) ORGANIZATION 
PURSUANT TO SECTIONS 1851 THROUGH 1859 OF THE SOCIAL SECURITY ACT 
FOR THE OPERATION OF A MEDICARE ADVANTAGE COORDINATED CARE PLAN(S)

CONTRACT (H1032)

Between

Centers for Medicare & Medicaid Services (hereinafter referred to as CMS)

and

WELLCARE OF FLORIDA, INC. 
(hereinafter referred to as the MA Organization)

CMS and the MA Organization, an entity which has been determined to be an eligible Medicare Advantage Organization by the Administrator of the Centers for Medicare & Medicaid Services under 42 CFR §422.503, agree to the following for the purposes of §§ 1851 through 1859 of the Social Security Act (hereinafter referred to as
the Act):

(NOTE: Citations  indicated  in brackets are placed in the text of this contract  to note the regulatory authority for certain contract provisions.  All references to Part 422 are to 42 CFR Part 422.)

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Article I 
Term of Contract

The term of this contract shall be from the date of signature by CMS' authorized representative through December 31, 2015, after which this contract may be renewed for successive one-year periods in accordance with 42 CFR §422.505(c) and as discussed in Paragraph A of Article VII below. [422.505]

This contract governs the respective rights and obligations of the parties as of the effective date set forth above, and supersedes any prior agreements between the MA Organization and CMS as of such date. MA organizations offering Part D benefits also must execute an Addendum to the Medicare Managed Care Contract Pursuant to §§ 1860D-1 through 1860D-43 of the Social Security Act for the Operation of a Voluntary Medicare Prescription Drug Plan (hereafter the "Part D Addendum"). For MA Organizations offering MA-PD plans, the Part D Addendum governs the rights and obligations of the parties relating to the provision of Part D benefits, in accordance with its terms, as of its effective date.

Article II 
Coordinated Care Plan

A. The MA Organization agrees to operate one or more coordinated care plans as defined in 42 CFR §422.4(a)(1)(iii)), including at least one MA-PD plan as required under 42 CFR 422.4(c), as described in its final Plan Benefit Package (PBP) bid submission (benefit and price bid) proposal as approved by CMS and as attested to in the Medicare Advantage Attestation of Benefit Plan and Price, and in compliance with the requirements of this contract and applicable Federal statutes, regulations, and policies (e.g., policies as described in the Call Letter, Medicare Managed Care Manual, etc.).

B. Except as provided in paragraph (C) of this Article, this contract is deemed to incorporate any changes that are required by statute to be implemented during the term of the contract and any regulations or policies implementing or interpreting such statutory provisions.

C. CMS will not implement, other than at the beginning of a calendar year, requirements under 42 CFR Part 422 that impose a new significant cost or burden on MA organizations or plans, unless a different effective date is required by statute. [422.521]

D. If the MA Organization had a contract with CMS for Contract Year 2014 under the contract ID number designated above, this document is considered a renewal of the existing contract. While the terms of this document supersede the terms of the 2014 contract, the parties' execution of this contract does not extinguish or interrupt any pending obligations or actions that may have arisen under the 2014 or prior year contracts.

E. This contract is in no way intended to supersede or modify 42 CFR, Part 422. Failure to reference a regulatory requirement in this contract does not affect the applicability of such requirements to the MA organization and CMS.

Article III
Functions To Be Performed By Medicare Advantage Organization

A. PROVISION OF BENEFITS

1. The MA Organization agrees to provide enrollees in each of its MA plans the basic benefits as required under 42 CFR §422.101 and, to the extent applicable, supplemental benefits under 42 CFR §422.102 and as established in the MA Organization's final benefit and price bid proposal as approved by CMS and listed in the MA Organization Plan Attestation of Benefit Plan and Price, which is attached to this contract. The MA Organization agrees to provide access to such benefits as required under subpart C in a manner consistent with professionally recognized standards of health care and according to the access standards stated in 42 CFR §422.112.

2. The MA Organization agrees to provide post-hospital extended care services, should an MA enrollee elect such coverage, through a home skilled nursing facility, as defined at 42 CFR §422.133(b), according to the 

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requirements of § 1852(l) of the Act and 42 CFR §422.133. [422. 133; 422.504(a)(3)]

B. ENROLLMENT REQUIREMENTS

1. The MA Organization agrees to accept new enrollments, make enrollments effective, process voluntary disenrollments, and limit involuntary disenrollments, as provided in 42 CFR Part 422, Subpart B.

2. The MA Organization shall comply with the provisions of 42 CFR §422.110 concerning prohibitions against discrimination in beneficiary enrollment, other than in enrolling eligible beneficiaries in a CMA-approved special needs plan that exclusively enrolls special needs individuals as consistent with 42 CFR §§422.2, 422.4(a)(1)(iv) and 422.52. [422.504(a)(2)]

C. BENEFICIARY PROTECTIONS

1. The MA Organization agrees to comply with all requirements in 42 CFR O Part 422, Subpart M governing coverage determinations, grievances, and appeals. [422.504(a)(7)]

2. The MA Organization agrees to comply with the confidentiality and enrollee record accuracy requirements in
42 CFR §422.118.

3. Beneficiary Financial Protections. The MA Organization agrees to comply with the following requirements:

(a) Each MA Organization must adopt and maintain arrangements satisfactory to CMS to protect its
enrollees from incurring liability for payment of any fees that are the legal obligation of the MA Organization. To meet this requirement the MA Organization must-

(i) Ensure that all contractual or other written arrangements with providers prohibit the Organization's providers from holding any beneficiary enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and

(ii) Indemnify the beneficiary enrollee for payment of any fees that are the legal obligation of the MA Organization for services furnished by providers that do not contract, or that have not otherwise entered into an agreement with the MA Organization, to provide services to the organization's beneficiary enrollees. [422.504(g)(1)]

(b) The MA Organization must provide for continuation of enrollee health care benefits-

(i) For all enrollees, for the duration of the contract period for which CMS payments have been made; and

(ii) For enrollees who are hospitalized on the date its contract with CMS terminates, or, in the event of the MA Organization's insolvency, through the date of discharge. [422.504(g)(2)]

(c) In meeting the requirements of this paragraph, other than the provider contract requirements specified in subparagraph 3(a) of this paragraph, the MA Organization may use-

(i) Contractual arrangements;

(ii) Insurance acceptable to CMS;

(iii) Financial reserves acceptable to CMS; or

(iv) Any other arrangement acceptable to CMS. [422.504(g)(3)]

D. PROVIDER PROTECTIONS

1. The MA Organization agrees to comply with all applicable provider requirements in 42 CFR Part 422 Subpart E, including provider certification requirements, anti-discrimination requirements, provider participation and consultation requirements, the prohibition on interference with provider advice, limits on provider indemnification, rules governing payments to providers, and limits on physician incentive plans. [422.504(a)(6)]

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2. Prompt Payment.

(a) The MA Organization must pay 95 percent of "clean claims" within 30 days of receipt if they are claims for covered services that are not furnished under a written agreement between the organization and the provider.

(i) The MA Organization must pay interest on clean claims that are not paid within 30 days in accordance with §§ 1816(c)(2) and 1842(c)(2) of the Act.

(ii) All other claims from non-contracted providers must be paid or denied within 60 calendar days from the date of the request. [422.520(a)]

(b) Contracts or other written agreements between the MA Organization and its providers must contain a prompt payment provision, the terms of which are developed and agreed to by both the MA Organization and the relevant provider. [422.520(b)]

(c) If CMS determines, after giving notice and opportunity for hearing, that the MA Organization has failed to make payments in accordance with subparagraph (2)(a) of this paragraph, CMS may provide-

(i) For direct payment of the sums owed to providers; and

(ii) For appropriate reduction in the amounts that would otherwise be paid to the MA Organization, to reflect the amounts of the direct payments and the cost of making those payments. [422.520(c)]

E. QUALITY IMPROVEMENT PROGRAM

1. The MA Organization agrees to operate, for each plan that it offers, an ongoing quality improvement program as stated in accordance with § 1852(e) of the Social Security Act and 42 CFR §422.152.

2. Chronic Care Improvement Program

(a) Each MA organization must have a chronic care improvement program and must establish criteria for participation in the program. The CCIP must have a method for identifying enrollees with multiple or sufficiently severe chronic conditions who meet the criteria for participation in the program and a mechanism for monitoring enrollees' participation in the program.

(b) Plans have flexibility to choose the design of their program; however, in addition to meeting the requirements specified above, the CCIP selected must be relevant to the plan's MA population. MA organizations are required to submit annual reports on their CCIP program to CMS.

3. Performance Measurement and Reporting: The MA Organization shall measure performance under its MA plans using standard measures required by CMS, and report (at the organization level) its performance to CMS. The standard measures required by CMS during the term of this contract will be uniform data collection and reporting instruments, to include the Health Plan and Employer Data Information Set (HEDIS), Consumer Assessment of Health Plan Satisfaction (CAHPS) survey, and Health Outcomes Survey (HOS). These measures will address clinical areas, including effectiveness of care, enrollee perception of care and use of services; and non-clinical areas including access to and availability of services, appeals and grievances, and organizational characteristics. [422.152(b)(1), (e)]

4. Utilization Review:

(a) An MA Organization for an MA coordinated care plan must use written protocols for utilization review and policies and procedures must reflect current standards of medical practice in processing requests for initial or continued authorization of services and have in effect mechanisms to detect both underutilization and over utilization of services. [422.152(b)]

(b) For MA regional preferred provider organizations (RPPOs) and MA local preferred provider organizations (PPOs) that are offered by an organization that is not licensed or organized under State law as an HMOs, if the MA Organization uses written protocols for utilization review, those policies and procedures must reflect current standards of 

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medical practice in processing requests for initial or continued authorization of services and include mechanisms to evaluate utilization of services and to inform enrollees and providers of services of the results of the evaluation [422.152(e)]
5. Information Systems:

(a) The MA Organization must:

(i) Maintain a health information system that collects, analyzes and integrates the data necessary to implement its quality improvement program;

(ii) Ensure that the information entered into the system (particularly that received from providers) is reliable and complete;

(iii) Make all collected information available to CMS. [422.152(f)(1)]

6. External Review: The MA Organization will comply with any requests by Quality Improvement Organizations to review the MA Organization's medical records in connection with appeals of discharges from hospitals, skilled nursing facilities, and home health agencies.

7. The MA Organization agrees to address complaints received by CMS against the MA Organization as required in 42 CFR §422.504(a)(15) by:

(a) Addressing and resolving complaints in the CMS complaint tracking system; and

(b) Displaying a link to the electronic complaint form on the Medicare.gov Internet Web site on the MA plan's main Web page.

F. COMPLIANCE PLAN

The MA Organization agrees to implement a compliance plan in accordance with the requirements of 42 CFR §422.503(b)(4)(vi). [422.503(b)(4)(vi)]

G. COMPLIANCE DEEMED ON THE BASIS OF ACCREDITATION

CMS may deem the MA Organization to have met the quality improvement requirements of §1852(e) of the Act and 42 CFR §422.152, the confidentiality and accuracy of enrollee records requirements of §1852(h) of the Act and 42 CFR §422.118, the anti-discrimination requirements of §1852(b) of the Act and 42 CFR §422.110, the access to services requirements of §1852(d) of the Act and 42 CFR §422.112, the advance directives requirements of §1852(i) of the Act and 42 CFR §422.128, the provider participation requirements of §1852(j) of the Act and 42 CFR Part 422, Subpart E, and the applicable requirements described in 42 CFR §423.156, if the MA Organization is fully accredited (and periodically reaccredited) by a private, national accreditation organization approved by CMS and the accreditation organization used the standards approved by CMS for the purposes of assessing the MA Organization's compliance with Medicare requirements. The provisions of 42 CFR §422.156 shall govern the MA Organization's use of deemed status to meet MA program requirements.

H. PROGRAM INTEGRITY

1. The MA Organization agrees to provide notice based on best knowledge, information, and belief to CMS of any integrity items related to payments from governmental entities, both federal and state, for healthcare or prescription drug services. These items include any investigations, legal actions or matters subject to arbitration brought involving the MA Organization (or MA Organization's firm if applicable) and its subcontractors (excluding contracted network providers), including any key management or executive staff, or any major shareholders (5% or more), by a government agency (state or federal) on matters relating to payments from governmental entities, both federal and state, for healthcare and/or prescription drug services. In providing the notice, the sponsor shall keep the government informed of when the integrity item is initiated and when it is closed. Notice should be provided of the details concerning any resolution and monetary payments as well as any settlement agreements or corporate integrity agreements.

2. The MA Organization agrees to provide notice based on best knowledge, information, and belief to CMS in the event the MA Organization or any of its subcontractors is criminally convicted or has a civil judgment entered against it for 

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fraudulent activities or is sanctioned under any Federal program involving the provision of health care or prescription drug services.
I. MARKETING

1. The MA Organization may not distribute any marketing materials, as defined in 42 CFR §422.2260 and in the Marketing Materials Guidelines for Medicare Advantage-Prescription Drug Plans and Prescription Drug Plans (Medicare Marketing Guidelines), unless they have been filed with and not disapproved by CMS in accordance with 42 CFR §422.2264. The file and use process set out at 42 CFR §422.2262 must be used, unless the MA organization notifies CMS that it will not use this process.

2. CMS and the MA Organization shall agree upon language setting forth the benefits, exclusions and other language of the Plan. The MA Organization bears full responsibility for the accuracy of its marketing materials. CMS, in its sole discretion, may order the MA Organization to print and distribute the agreed upon marketing materials, in a format approved by CMS. The MA Organization must disclose the information to each enrollee electing a plan as outlined in 42 CFR §422.111.

3. The MA Organization agrees that any advertising material, including that labeled promotional material, marketing materials, or supplemental literature, shall be truthful and not misleading. All marketing materials must include the Contract number. All membership identification cards must include the Contract number on the front of the card.

4. The MA Organization must comply with the Medicare Marketing Guidelines, as well as all applicable statutes and regulations, including and without limitation § 1851(h) of the Act and 42 CFR § 422.111, 42 CFR Part 422 Subpart V and 42 CFR Part 423 Subpart V. Failure to comply may result in sanctions as provided in 42 CFR Part 422 Subpart O.

Article IV
CMS Payment to MA Organization

A. The MA Organization agrees to develop its annual benefit and price bid proposal and submit to CMS all required information on premiums, benefits, and cost sharing, as required under 42 CFR Part 422 Subpart F. [422.504(a)(10)]

B. METHODOLOGY

CMS agrees to pay the MA Organization under this contract in accordance with the provisions of § 1853 of the Act and 42 CFR Part 422 Subpart G. [422.504(a)(9)]

C. ELECTRONIC HEALTH RECORDS INCENTIVE PROGRAM PAYMENTS

The MA Organization agrees to abide by the requirements in 42 CFR §§495.200 et seq. and §1853(l) and (m) of the Act, including the fact that payment will be made directly to MA-affiliated hospitals that are certified Medicare hospitals through the Medicare FFS hospital incentive payment program.

D. ATTESTATION OF PAYMENT DATA (Attachments A, B, and C).

As a condition for receiving a monthly payment under paragraph B of this article, and 42 CFR Part 422 Subpart G, the MA Organization agrees that its chief executive officer (CEO), chief financial officer (CFO), or an individual delegated with the authority to sign on behalf of one of these officers, and who reports directly to such officer, must request payment under the contract on the forms attached hereto as Attachment A (enrollment attestation) and Attachment B (risk adjustment data) which attest to (based on best knowledge, information and belief, as of the date specified on the attestation form) the accuracy, completeness, and truthfulness of the data identified on these attachments. The Medicare Advantage Plan Attestation of Benefit Plan and Price must be signed and attached to the executed version of this contract.
(NOTE: The forms included as attachments to this contract are for reference only. CMS will provide instructions for the completion and submission of the forms in separate documents. MA Organizations should not take any action on the forms until appropriate CMS instructions become available.)

1. Attachment A requires that the CEO, CFO, or an individual delegated with the authority to sign on behalf of one 

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of these officers, and who reports directly to such officer, must attest based on best knowledge, information, and belief that each enrollee for whom the MA Organization is requesting payment is validly enrolled, or was validly enrolled during the period for which payment is requested, in an MA plan offered by the MA Organization. The MA Organization shall submit completed enrollment attestation forms to CMS, or its contractor, on a monthly basis.

2. Attachment B requires that the CEO, CFO, or an individual delegated with the authority to sign on behalf of one of these officers, and who reports directly to such officer, must attest to (based on best knowledge, information and belief, as of the date specified on the attestation form) that the risk adjustment data it submits to CMS under 42 CFR §422.310 are accurate, complete, and truthful. The MA Organization shall make annual attestations to this effect for risk adjustment data on Attachment B and according to a schedule to be published by CMS. If such risk adjustment data are generated by a related entity, contractor, or subcontractor of an MA Organization, such entity, contractor, or subcontractor must also attest to (based on best knowledge, information, and belief, as of the date specified on the attestation form) the accuracy, completeness, and truthfulness of the data. [422.504(l)]

3. The Medicare Advantage Plan Attestation of Benefit Plan and Price (an example of which is attached hereto as Attachment C) requires that the CEO, CFO, or an individual delegated with the authority to sign on behalf of one of these officers, and who reports directly to such officer, must attest (based on best knowledge, information and belief, as of the date specified on the attestation form) that the information and documentation comprising the bid submission proposal is accurate, complete, and truthful and fully conforms to the Bid Form and Plan Benefit Package requirements; and that the benefits described in the CMS-approved proposed bid submission agree with the benefit package the MA Organization will offer during the period covered by the proposed bid submission. This document is being sent separately to the MA Organization and must be signed and attached to the executed version of this contract, and is incorporated herein by reference. [422.504(l)]

4. The MA Organization must certify based on best knowledge, information, and belief, that the information provided for the purposes of reporting and returning of overpayments under 42 CFR §422.326 is accurate, complete, and truthful. The form for this certification will be determined by CMS. [422.504(l)]

Article V
MA Organization Relationship with Related Entities, Contractors, and Subcontractors

A. Notwithstanding any relationship(s) that the MA Organization may have with related entities, contractors, or subcontractors, the MA Organization maintains full responsibility for adhering to and otherwise fully complying with all terms and conditions of its contract with CMS. [422.504(i)(1)]

B. The MA Organization agrees to require all related entities, contractors, or subcontractors to agree that-

1. HHS, the Comptroller General, or their designees have the right to audit, evaluate, collect, and inspect any books, contracts, computer or other electronic systems, including medical records and documentation of the first tier, downstream, and related entities related to CMS contract with the MA organization;

2. HHS, the Comptroller General, or their designees have the right to audit, evaluate, collect, and inspect any records under paragraph B (1) of this Article directly from any first tier, downstream, to related entity;

3. For records subject to review under paragraph B(2) of this Article, except in exceptional circumstances, CMS will provide notification to the MA organization that a direct request for information has been initiated; and

4. HHS, the Comptroller General, or their designees have the right to inspect, evaluate, and audit any pertinent information for any particular contract period for 10 years from the final date of the contract period or from the date of completion of any audit, whichever is later. [422.504(i)(2)]

C. The MA Organization agrees that all contracts or written arrangements into which the MA Organization enters with providers, related entities, contractors, or subcontractors (first tier and downstream entities) shall contain the following elements:

1. Enrollee protection provisions that provide-

(a) Consistent with Article III, paragraph C, arrangements that prohibit providers from holding an enrollee liable for payment of any fees that are the legal obligation of the MA Organization; and

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(b) Consistent with Article III, paragraph C, provision for the continuation of benefits.

2. Accountability provisions that indicate that the MA Organization may only delegate activities or functions to a provider, related entity, contractor, or subcontractor in a manner consistent with requirements set forth at paragraph D of this Article.

3. A provision requiring that any services or other activity performed by a first tier, downstream, or related entity in accordance with a contract or written agreement will be consistent and comply with the MA Organization's contractual obligations. [422.504(i)(3)]

D. If any of the MA Organization's activities or responsibilities under this contract with CMS is delegated to other parties, the following requirements apply to any first tier, downstream, or related entity:

1. Each and every contract must specify delegated activities and reporting responsibilities.

2. Each and every contract must either provide for revocation of the delegation activities and reporting requirements or specify other remedies in instances where CMS or the MA Organization determine that such parties have not performed satisfactorily.

3. Each and every contract must specify that the performance of the parties is monitored by the MA Organization on an ongoing basis.

4. Each and every contract must specify that either-

(a) The credentials of medical professionals affiliated with the party or parties will be either reviewed by the MA Organization; or

(b) The credentialing process will be reviewed and approved by the MA Organization and the MA Organization must audit the credentialing process on an ongoing basis.

5. Each and every contract must specify that the first tier, downstream, or related entity comply with all applicable Medicare laws, regulations, and CMS instructions. [422.504(i)(4)]

E. If the MA Organization delegates selection of the providers, contractors, or subcontractors to another organization, the MA Organization's contract with that organization must state that the CMS-contracting MA Organization retains the right to approve, suspend, or terminate any such arrangement. [422.504(i)(5)]

F. As of the date of this contract and throughout its term, the MA Organization

1. Agrees that any physician incentive plan it operates meets the requirements of 42 CFR §422.208, and

2. Has assured that all physicians and physician groups that the MA Organization's physician incentive plan places at substantial financial risk have adequate stop-loss protection in accordance with 42 CFR §422.208(f). [422.208]

Article VI Records Requirements

A. MAINTENANCE OF RECORDS

1. The MA Organization agrees to maintain for 10 years books, records, documents, and other evidence of accounting procedures and practices that-

(a) Are sufficient to do the following:

(i) Accommodate periodic auditing of the financial records (including data related to Medicare utilization, costs, and computation of the benefit and price bid) of the MA Organization.

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(ii) Enable CMS to inspect or otherwise evaluate the quality, appropriateness and timeliness of services performed under the contract, and the facilities of the MA Organization.

(iii) Enable CMS to audit and inspect any books and records of the MA Organization that pertain to the ability of the organization to bear the risk of potential financial losses, or to services performed or determinations of amounts payable under the contract.

(iv) Properly reflect all direct and indirect costs claimed to have been incurred and used in the preparation of the benefit and price bid proposal.

(v) Establish component rates of the benefit and price bid for determining additional and supplementary benefits.

(vi) Determine the rates utilized in setting premiums for State insurance agency purposes and for other government and private purchasers; and

(b) Include at least records of the following:

(i) Ownership and operation of the MA Organization's financial, medical, and other record keeping systems.
(ii) Financial statements for the current contract period and ten prior periods.

(iii) Federal income tax or informational returns for the current contract period and ten prior periods.

(iv) Asset acquisition, lease, sale, or other action.

(v) Agreements, contracts (including, but not limited to, with related or unrelated prescription drug benefit managers) and subcontracts.

(vi) Franchise, marketing, and management agreements.

(vii) Schedules of charges for the MA Organization's fee-for-service patients.

(viii) Matters pertaining to costs of operations.

(ix) Amounts of income received, by source and payment. 

(x) Cash flow statements.

(xi) Any financial reports filed with other Federal programs or State authorities.[422.504(d)]

2. Access to facilities and records. The MA Organization agrees to the following:

(a) The Department of Health and Human Services (HHS), the Comptroller General, or their designee may evaluate, through inspection or other means-

(i) The quality, appropriateness, and timeliness of services furnished to Medicare enrollees under the contract;

(ii) The facilities of the MA Organization; and

(iii) The enrollment and disenrollment records for the current contract period and ten prior periods.

(b) HHS, the Comptroller General, or their designees may audit, evaluate, or inspect any books, contracts, medical records, documents, papers, patient care documentation, and other records of the MA Organization, related entity, contractor, subcontractor, or its transferee that pertain to any aspect of services performed, 

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reconciliation of benefit liabilities, and determination of amounts payable under the contract, or as the Secretary may deem necessary to enforce the contract.

(c) The MA Organization agrees to make available, for the purposes specified in paragraph A of this Article, its premises, physical facilities and equipment, records relating to its Medicare enrollees, and any additional relevant information that CMS may require, in a manner that meets CMS record maintenance requirements.

(d) HHS, the Comptroller General, or their designee's right to inspect, evaluate, and audit extends through
10 years from the final date of the contract period or completion of audit, whichever is later unless-

(i) CMS determines there is a special need to retain a particular record or group of records for a longer period and notifies the MA Organization at least 30 days before the normal disposition date;

(ii) There has been a termination, dispute, or fraud or similar fault by the MA Organization, in which case the retention may be extended to 10 years from the date of any resulting final resolution of the termination, dispute, or fraud or similar fault; or

(iii) HHS, the Comptroller General, or their designee determines that there is a reasonable possibility of fraud, in which case they may inspect, evaluate, and audit the MA Organization at any time. [422.504(e)]

B. REPORTING REQUIREMENTS

1. The MA Organization shall have an effective procedure to develop, compile, evaluate, and report to CMS, to its enrollees, and to the general public, at the times and in the manner that CMS requires, and while safeguarding the confidentiality of the doctor patient relationship, statistics and other information as described in the
remainder of this paragraph. [422.516(a)]

2. The MA Organization agrees to submit to CMS certified financial information that must include the following:

(a) Such information as CMS may require demonstrating that the organization has a fiscally sound operation, including:

(i) The cost of its operations;

(ii) A description, submitted to CMS annually and within 120 days of the end of the fiscal year, of significant business transactions (as defined in 42 CFR §422.500) between the MA Organization and a party in interest showing that the costs of the transactions listed in subparagraph (2)(a)(v) of this paragraph do not exceed the costs that would be incurred if these transactions were with someone who is not a party in interest; or

(iii) If they do exceed, a justification that the higher costs are consistent with prudent management and fiscal soundness requirements.

(iv) A combined financial statement for the MA Organization and a party in interest if either of the following conditions is met:

(aa) Thirty five percent or more of the costs of operation of the MA Organization go to a party in interest.

(bb) Thirty five percent or more of the revenue of a party in interest is from the MA Organization.
[422.516(b)]

(v) Requirements for combined financial statements.

(aa) The combined financial statements required by this subparagraph must display in separate columns the financial information for the MA Organization and each of the parties in interest.

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(bb) Inter-entity transactions must be eliminated in the consolidated column.

(cc) The statements must have been examined by an independent auditor in accordance with generally accepted accounting principles and must include appropriate opinions and notes.

(dd) Upon written request from the MA Organization showing good cause, CMS may waive the requirement that the organization's combined financial statement include the financial information required in this subparagraph with respect to a particular entity. [422.516(c)]

(vi) A description of any loans or other special financial arrangements the MA Organization makes with contractors, subcontractors, and related entities. [422.516(e)]

(b) Such information as CMS may require pertaining to the disclosure of ownership and control of the MA Organization. [422.504(f)]

(c) Patterns of utilization of the MA Organization's services. [422.516(a)(2)]
3. The MA Organization agrees to participate in surveys required by CMS and to submit to CMS all information that is necessary for CMS to administer and evaluate the program and to simultaneously establish and facilitate a process for current and prospective beneficiaries to exercise choice in obtaining Medicare services. This information includes, but is not limited to:

(a) The benefits covered under the MA plan;

(b) The MA monthly basic beneficiary premium and MA monthly supplemental beneficiary premium, if any, for the plan.

(c) The service area and continuation area, if any, of each plan and the enrollment capacity of each plan;

(d) Plan quality and performance indicators for the benefits under the plan including -

(i) Disenrollment rates for Medicare enrollees electing to receive benefits through the plan for the previous 2 years;

(ii) Information on Medicare enrollee satisfaction; 

(iii) The patterns of utilization of plan services;

(iv) The availability, accessibility, and acceptability of the plan's services;

(v) Information on health outcomes and other performance measures required by CMS;

(vi) The recent record regarding compliance of the plan with requirements of this part, as determined by CMS; and

(vii) Other information determined by CMS to be necessary to assist beneficiaries in making an informed choice among MA plans and traditional Medicare;

(viii) Information about beneficiary appeals and their disposition;

(ix) Information regarding all formal actions, reviews, findings, or other similar actions by States, other regulatory bodies, or any other certifying or accrediting organization;

(x) Any other information deemed necessary by CMS for the administration or evaluation of the
Medicare program. [422.504(f)(2)]

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4. The MA Organization agrees to provide to its enrollees and upon request, to any individual eligible to elect an MA plan, all informational requirements under 42 CFR §422.64 and, upon an enrollee's, request, the financial disclosure information required under 42 CFR §422.516. [422.504(f)(3)]

5. Reporting and disclosure under ERISA -

(a) For any employees' health benefits plan that includes an MA Organization in its offerings, the MA Organization must furnish, upon request, the information the plan needs to fulfill its reporting and disclosure obligations (with respect to the MA Organization) under the Employee Retirement Income Security Act of 1974 (ERISA).

(b) The MA Organization must furnish the information to the employer or the employer's designee, or to the plan administrator, as the term "administrator" is defined in ERISA. [422.516(d)]

6. Electronic communication. The MA Organization must have the capacity to communicate with CMS
electronically. [422.504(b)]

7. Risk Adjustment data. The MA Organization agrees to comply with the requirements in 42 CFR §422.310 for submitting risk adjustment data to CMS. [422.504(a)(8)]

8. The MA Organization acknowledges that CMS releases to the public summary reconciled Part D Payment data after the reconciliation of Part C and Part D Payments for the contract year as provided in 42 CFR §422.504(n) and, for Part D plan sponsors, 42 CFR §423.505(o).

Article VII
Renewal of the MA Contract

A. RENEWAL OF CONTRACT

In accordance with 42 CFR §422.505, following the initial contract period, this contract is renewable annually only if-

1. The MA Organization has not provided CMS with a notice of intention not to renew; [422.506(a)]

2. CMS and the MA Organization reach agreement on the bid under 42 CFR Part 422, Subpart F; and
[422.505(d)]

3. CMS informs the MA Organization that it authorizes a renewal. 

B. NONRENEWAL OF CONTRACT

1. Nonrenewal by the Organization.

(a) In accordance with 42 CFR §422.506, the MA Organization may elect not to renew its contract with CMS as of the end of the term of the contract for any reason, provided it meets the time frames for doing so set forth in this subparagraph.

(b) If the MA Organization does not intend to renew its contract, it must notify-

(i) CMS, in writing, by the first Monday in June of the year in which the contract would end, pursuant to
42 CFR §422.506

(ii) Each Medicare enrollee by mail, at least 90 calendar days before the date on which the nonrenewal is effective. This notice must include a written description of all alternatives available for obtaining Medicare services within the service area including alternative MA plans, MA-PD plans, Medigap options, and original Medicare and prescription drug plans and must receive CMS approval prior to issuance.

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H1032

(c) CMS may accept a nonrenewal notice submitted after the applicable annual non-renewal notice deadline if -

(i) The MA Organization notifies its Medicare enrollees and the public in accordance with subparagraph
(1)(b)(ii) of this paragraph; and

(ii) Acceptance is not inconsistent with the effective and efficient administration of the Medicare program.

(d) If the MA Organization does not renew a contract under this subparagraph, CMS will not enter into a contract with the Organization or with any organization whose covered persons, as defined at 42 CFR
§422.506(a)(5), also served as covered persons for the non-renewing MA Organization for 2 years unless there are special circumstances that warrant special consideration, as determined by CMS. [422.506(a)]

2. CMS decision not to renew.

(a) CMS may elect not to authorize renewal of a contract for any of the following reasons:

(i) For any of the reasons listed in 42 CFR §422.510(a) which would also permit CMS to terminate the contract.

(ii) The MA Organization has committed any of the acts in 42 CFR §422.752(a) that would support the imposition of intermediate sanctions or civil money penalties under 42 CFR Part 422 Subpart O.

(iii) The MA Organization did not submit a benefit and price bid or the benefit and price bid was not acceptable [422.505(d)]

(b) Notice. CMS shall provide notice of its decision whether to authorize renewal of the contract as follows:

(i) To the MA Organization by August 1 of the contract year, except in the event described in subparagraph (2)(a)(iii) of this paragraph, for which notice will be sent by September 1.

(ii) To the MA Organization's Medicare enrollees by mail at least 90 days before the end of the current calendar year.

(c) Notice of appeal rights. CMS shall give the MA Organization written notice of its right to reconsideration of the decision not to renew in accordance with 42 CFR §422.644.[422.506(b)]

Article VIII
Modification or Termination of the Contract

A. MODIFICATION OR TERMINATION OF CONTRACT BY MUTUAL CONSENT

1. This contract may be modified or terminated at any time by written mutual consent.

(a) If the contract is modified by written mutual consent, the MA Organization must notify its Medicare enrollees of any changes that CMS determines are appropriate for notification within time frames specified by CMS. [422.508(a)(2)]

(b) If the contract is terminated by written mutual consent, except as provided in subparagraph 2 of this paragraph, the MA Organization must provide notice to its Medicare enrollees and the general public as provided in paragraph B, subparagraph 2(b) of this Article. [422.508(a)(1)]

2. If this contract is terminated by written mutual consent and replaced the day following such termination by a new MA contract, the MA Organization is not required to provide the notice specified in paragraph B of this Article. [422.508(b)]

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B. TERMINATION OF THE CONTRACT BY CMS OR THE MA ORGANIZATION

1. Termination by CMS.

(a) CMS may at any time terminate a contract if CMS determines that the MA Organization meets any of the following:

(i) has failed substantially to carry out the terms of its contract with CMS.

(ii) is carrying out its contract in a manner that is inconsistent with the efficient and effective implementation of 42 CFR Part 422.

(iii) no longer substantially meets the applicable conditions of 42CFR Part 422.

(iv) based on creditable evidence, has committed or participated in false, fraudulent or abusive activities affecting the Medicare, Medicaid or other State or Federal health care program, including submission of false or fraudulent data.

(v) experiences financial difficulties so severe that its ability to make necessary health services available is impaired to the point of posing an imminent and serious risk to the health of its enrollees, or otherwise fails to make services available to the extent that such a risk to health exists.

(vi) substantially fails to comply with the requirements in 42 CFR Part 422 Subpart M relating to grievances and appeals.

(vii) fails to provide CMS with valid risk adjustment data as required under 42 CFR §§422.310 and
423.329(b)(3).

(viii) fails to implement an acceptable quality improvement program as required under 42 CFR Part 422
Subpart D.

(ix) substantially fails to comply with the prompt payment requirements in 42 CFR §422.520.

(x) substantially fails to comply with the service access requirements in 42 CFR §422.112.

(xi) fails to comply with the requirements of 42 CFR §422.208 regarding physician incentive plans. 

(xii) substantially fails to comply with the marketing requirements in 42 CFR Part 422 Subpart V.

(b) CMS may make a determination under paragraph B(1)(a)(i), (ii), or (iii) of this Article if the MA Organization has had one or more of the following occur:

(i)  based on creditable evidence, has committed or participated in false, fraudulent or abusive activities affecting the Medicare, Medicaid or other State or Federal health care program, including submission of false or fraudulent data.

(ii) experiences financial difficulties so severe that its ability to make necessary health services available is impaired to the point of posing an imminent and serious risk to the health of its enrollees, or otherwise fails to make services available to the extent that such a risk to health exists.

(iii) substantially failed to comply with the requirements in 42 CFR Part 422 Subpart M relating to grievances and appeals.

(iv) failed to provide CMS with valid data as required under 42 CFR §§422.310.

Page 14 of 21
H1032

(v) failed to implement an acceptable quality assessment and performance improvement program as required under 42 CFR Part 422 Subpart D.

(vi) substantially failed to comply with the prompt payment requirements in 42 CFR §422.520.

(vii) substantially failed to comply with the service access requirements in 42 CFR §422.112.

(viii) failed to comply with the requirements of 42 CFR §422.208 regarding physician incentive plans.

(ix) substantially failed to comply with the marketing requirements in 42 CFR Part 422 Subpart V.

(x) Failed to comply with regulatory requirements contained in 42 CFR Parts 422 or 423 or both.

(xi) Failed to meet CMS performance requirements in carrying out the regulatory requirements contained in 42 CFR Parts 422 or 423 or both.

(xii) Achieves a Part C summary plan rating of less than 3 stars for 3 consecutive contract years.

(xiii) Has failed to report MLR data in a timely and accurate manner in accordance with 42 CFR §422.2460.

(c) Notice. If CMS decides to terminate a contract, it will give notice of the termination as follows:

(i) CMS will notify the MA Organization in writing at least 45 calendar days before the intended date of the termination. 

(ii) The MA Organization will notify its Medicare enrollees of the termination by mail at least 30 calendar days before the effective date of the termination.

(iii) The MA Organization will notify the general public of the termination at least 30 calendar days before the effective date of the termination by releasing a press statement to news media serving the affected community or county and posting the press statement prominently on the organizations Web site.

(d) Expedited termination of contract by CMS.

(i)  For terminations based on violations prescribed in subparagraph 1(b)(i) or (b)(ii) of this paragraph or if CMS determines that a delay in termination would pose an imminent and serious threat to the health of the individuals enrolled with the MA Organization, CMS will notify the MA Organization in writing that its contract has been terminated on a date specified by CMS. If a termination is effective in the middle of a month, CMS has the right to recover the prorated share of the capitation payments made to the MA Organization covering the period of the month following the contract termination.

(ii) CMS will notify the MA Organization's Medicare enrollees in writing of CMS' decision to terminate the MA Organization's contract. This notice will occur no later than 30 days after CMS notifies the plan of its decision to terminate this contract. CMS will simultaneously inform the Medicare enrollees of alternative options for obtaining Medicare services, including alternative MA Organizations in a similar geographic area and original Medicare.

(iii) CMS will notify the general public of the termination no later than 30 days after notifying the MA Organization of CMS' decision to terminate this contract. This notice will be published in one or more newspapers of general circulation in each community or county located in the MA Organization's service area.

(d) Corrective action plan

(i) General. Before providing a notice of intent to terminate a contract for reasons other than the grounds specified in subparagraph 1(a)(iv) or (v) of this paragraph, CMS will provide the MA Organization with notice specifying the MA Organization's deficiencies and a reasonable opportunity of at least 30 calendar days to develop and implement an approved corrective action plan to correct the deficiencies that are the basis of the 

Page 15 of 21
H1032

proposed termination.

(ii) Exceptions. If a contract is terminated under subparagraph 1(a)(iv) or (v) of this paragraph, the MA Organization will not be provided with the opportunity to develop and implement a corrective action plan.

(e) Appeal rights. If CMS decides to terminate this contract, it will send written notice to the MA Organization informing it of its termination appeal rights in accordance with 42 CFR Part 422 Subpart N. [422.510(d)]

2. Termination by the MA Organization

(a) Cause for termination. The MA Organization may terminate this contract if CMS fails to substantially carry out the terms of the contract.

(b) Notice. The MA Organization must give advance notice as follows:

(i) To CMS, at least 90 days before the intended date of termination. This notice must specify the reasons why the MA Organization is requesting contract termination.

(ii) To its Medicare enrollees, at least 60 days before the termination effective date. This notice must include a written description of alternatives available for obtaining Medicare services within the service area, including alternative MA and MA-PD plans, PDP plans, Medigap options, and original Medicare and must receive CMS approval.

(iii) To the general public at least 60 days before the termination effective date by publishing a CMS- approved notice in one or more newspapers of general circulation in each community or county located in the MA Organization's geographic area.

(c) Effective date of termination. The effective date of the termination will be determined by CMS and will be at least 90 days after the date CMS receives the MA Organization's notice of intent to terminate.

(d) CMS' liability. CMS' liability for payment to the MA Organization ends as of the first day of the month after the last month for which the contract is in effect, but CMS shall make payments for amounts owed prior to termination but not yet paid.

(e) Effect of termination by the organization. CMS will not enter into an agreement with the MA Organization or with an organization whose covered persons, as defined in 42 CFR §422.512(e)(2), also served as covered persons for the terminating MA Organization for a period of two years from the date the Organization has terminated this contract, unless there are circumstances that warrant special consideration, as determined by CMS. [422.512]

Article IX
Requirements of Other Laws and Regulations

A. The MA Organization agrees to comply with-

1. Federal laws and regulations designed to prevent or ameliorate fraud, waste, and abuse, including, but not limited to, applicable provisions of Federal criminal law, the False Claims Act (31 USC §§3729 et seq.) , and the anti-kickback statute (§ 1128B(b) of the Act): and

2. HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. [422.504(h)]

B. Pursuant to § 13112 of the American Recovery and Reinvestment Act of 2009 (ARRA), the MA Organization agrees that as it implements, acquires, or upgrades its health information technology systems, it shall utilize, where available, health information technology systems and products that meet standards and implementation specifications adopted under § 3004 of the Public Health Service Act, as amended by § 13101 of the ARRA.

C. The MA Organization maintains ultimate responsibility for adhering to and otherwise fully complying with all terms and conditions of its contract with CMS, notwithstanding any relationship(s) that the MA Organization may have with 

Page 16 of 21
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related entities, contractors, or subcontractors. [422.504(i)]

D. In the event that any provision of this contract conflicts with the provisions of any statute or regulation applicable to an MA Organization, the provisions of the statute or regulation shall have full force and effect.
Article X
Severability

The MA Organization agrees that, upon CMS' request, this contract will be amended to exclude any MA plan or State-licensed entity specified by CMS, and a separate contract for any such excluded plan or entity will be deemed to be in place when such a request is made. [422.504(k)]

Article XI Miscellaneous

A. DEFINITIONS

Terms not otherwise defined in this contract shall have the meaning given to such terms in 42 CFR Part 422.

B. ALTERATION TO ORIGINAL CONTRACT TERMS

The MA Organization agrees that it has not altered in any way the terms of this contract presented for signature by CMS. The MA Organization agrees that any alterations to the original text the MA Organization may make to this contract shall not be binding on the parties.

C. APPROVAL TO BEGIN MARKETING AND ENROLLMENT

The MA Organization agrees that it must complete CMS operational requirements prior to receiving CMS approval to begin Part C marketing and enrollment activities. Such activities include, but are not limited to, establishing and successfully testing connectivity with CMS systems to process enrollment applications (or contracting with an entity qualified to perform such functions on the MA Organization's Sponsor's behalf) and successfully demonstrating capability to submit accurate and timely price comparison data. To establish and successfully test connectivity, the MA Organization must, 1) establish and test physical connectivity to the CMS data center, 2) acquire user identifications and passwords, 3) receive, store, and maintain data necessary to perform enrollments and send and receive transactions to and from CMS, and 4) check and receive transaction status information.

D. MA Organization agrees to maintain a fiscally sound operation by at least maintaining a positive net worth
(total assets exceed total liabilities) as required in 42 CFR § 422.504(a)(14).

E. MA Organization agrees to maintain administrative and management capabilities sufficient for the organization to organize, implement, and control the financial, marketing, benefit administration, and quality improvement activities related to the delivery of Part C services as required by 42 CFR §422.504(a)(17).

F. MA Organization agrees to maintain a Part C summary plan rating score of at least 3 stars as required by 42
CFR §422.504(a)(18).

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H1032

ATTACHMENT A

ATTESTATION OF ENROLLMENT INFORMATION 
RELATING TO CMS PAYMENT
TO A MEDICARE ADVANTAGE ORGANIZATION

Pursuant to the contract(s) between the Centers for Medicare & Medicaid Services (CMS) and (INSERT NAME OF MA ORGANIZATION), hereafter referred to as the MA Organization, governing the operation of the following Medicare Advantage plans (INSERT PLAN IDENTIFICATION NUMBERS HERE), the MA Organization hereby requests payment under the contract, and in doing so, makes the following attestation concerning CMS payments to the MA Organization. The MA Organization acknowledges that the information described below directly affects the calculation of CMS payments to the MA Organization and that misrepresentations to CMS about the accuracy of such information may result in Federal civil action and/or criminal prosecution. This attestation shall not be considered a waiver of the MA Organization's right to seek payment adjustments from CMS based on information or data which does not become available until after the date the MA Organization submits this attestation.

1. The MA Organization has reported to CMS for the month of (INDICATE MONTH AND YEAR) all new enrollments, disenrollments, and appropriate changes in enrollees' status with respect to the above-stated MA plans. Based on best knowledge, information, and belief as of the date indicated below, all information submitted to CMS in this report is accurate, complete, and truthful.

2. The MA Organization has reviewed the CMS monthly membership report and reply listing for the month of (INDICATE MONTH AND YEAR) for the above-stated MA plans and has reported to CMS any discrepancies between the report and the MA Organization's records. For those portions of the monthly membership report and the reply listing to which the MA Organization raises no objection, the MA Organization, through the certifying CEO/CFO, will be deemed to have attested, based on best knowledge, information, and belief as of the date indicated below, to its accuracy, completeness, and truthfulness.

Page 18 of 21
H1032

ATTACHMENT B

ATTESTATION OF RISK ADJUSTMENT DATA INFORMATION RELATING TO 
CMS PAYMENT TO A MEDICARE ADVANTAGE ORGANIZATION

Pursuant to the contract(s) between the Centers for Medicare & Medicaid Services (CMS) and (INSERT NAME OF MA ORGANIZATION), hereafter referred to as the MA Organization, governing the operation of the following Medicare Advantage plans (INSERT PLAN IDENTIFICATION NUMBERS HERE), the MA Organization hereby requests payment under the contract, and in doing so, makes the following attestation concerning CMS payments to the MA Organization. The MA Organization acknowledges that the information described below directly affects the calculation of CMS payments to the MA Organization or additional benefit obligations of the MA Organization and that misrepresentations to CMS about the accuracy of such information may result in Federal civil action and/or criminal prosecution.

The MA Organization has reported to CMS during the period of (INDICATE DATES) all (INDICATE TYPE - DIAGNOSIS/ENCOUNTER) risk adjustment data available to the MA Organization with respect to the above-stated MA plans. Based on best knowledge, information, and belief as of the date indicated below, all information submitted to CMS in this report is accurate, complete, and truthful.

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H1032

ATTACHMENT C- Medicare Advantage  Plan Attestation of Benefit Plan and Price

Page 20 of 21
H1032

In witness whereof, the parties hereby execute this contract. 

This document has been electronically signed by:

FOR THE MA ORGANIZATION

	
				
	/s/ THOMAS TRAN
	 
	 
	 

	 
	 
	 
	 

	Contracting Official Name
	 
	 
	 

	
				
	8/28/2014 2:13:35 PM
	 
	 
	 

	 
	 
	 
	 

	Date
	 
	 
	 

	
				
	 
	 
	8735 Henderson Road
	 

	WELLCARE OF FLORIDA, INC.
	 
	TAMPA, FL 33634
	 

	 
	 
	 
	 

	Organization
	 
	Address
	 

FOR THE CENTERS FOR MEDICARE & MEDICAID SERVICES

	
				
	/s/ Kathryn A. Coleman
	 
	9/11/2014 1:10:21 PM
	 

	 
	 
	 
	 

	Kathryn A. Coleman
	 
	Date
	 

     Acting Director
Medicare Drug and Health
Plan Contract Administrative Group,
Center for Medicare

Page 21 of 21
H1032

Medicare Advantage Attestation of Benefit Plan
WELLCARE OF FLORIDA, INC.
H1032
Date: 08/28/2014

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 2015. 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 2014 and 2015, including but not limited to, the 2015 Call Letter, the 2015 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
	5
	WellCare Choice (HMO-POS)
	HMOPOS
	Renewal
	37.90
	8.10
	08/20/2014
	01/01/2015

	025
	0
	6
	WellCare Choice (HMO-POS)
	HMOPOS
	Renewal
	46.50
	8.10
	08/20/2014
	01/01/2015

	032
	0
	6
	WellCare Dividend (HMO-POS)
	HMOPOS
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	035
	0
	6
	WellCare Value (HMO-POS)
	HMOPOS
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	037
	0
	7
	WellCare Advance (HMO)
	HMO
	Renewal
	0.00
	N/A
	08/20/2014
	01/01/2015

	040
	0
	6
	WellCare Dividend (HMO-POS)
	HMOPOS
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	061
	0
	7
	WellCare Select (HMO SNP)
	HMO
	Renewal
	0.00
	19.90
	08/20/2014
	01/01/2015

	073
	0
	4
	WellCare Value (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	079
	0
	4
	WellCare Value (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	091
	0
	4
	WellCare Value (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	124
	0
	8
	WellCare Access (HMO SNP)
	HMO
	Renewal
	0.00
	17.70
	08/20/2014
	01/01/2015

	133
	0
	7
	WellCare Essential (HMO-POS)
	HMOPOS
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	170
	0
	7
	WellCare Access (HMO SNP)
	HMO
	Renewal
	0.00
	20.90
	08/20/2014
	01/01/2015

	173
	0
	5
	WellCare Essential (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	174
	0
	6
	WellCare Essential (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	175
	0
	7
	WellCare Liberty (HMO SNP)
	HMO
	Renewal
	0.00
	18.90
	08/20/2014
	01/01/2015

	176
	0
	8
	WellCare Liberty (HMO SNP)
	HMO
	Renewal
	0.00
	24.60
	08/20/2014
	01/01/2015

	177
	0
	4
	WellCare Value (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	179
	0
	4
	WellCare Dividend (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	180
	0
	6
	WellCare Dividend (HMO)
	HMO
	Renewal
	0.00
	0.00
	08/20/2014
	01/01/2015

	181
	0
	6
	WellCare Rx (HMO-POS)
	HMOPOS
	Renewal
	0.00
	17.90
	08/20/2014
	01/01/2015

H1032

	
				
	/s/ THOMAS TRAN
	 
	8/28/2014 2:13:35 PM
	 

	 
	 
	 
	 

	Contracting Official Name
	 
	Date
	 

	
				
	 
	 
	8735 Henderson Road
	 

	WELLCARE OF FLORIDA, INC.
	 
	TAMPA, FL 33634
	 

	 
	 
	 
	 

	Organization
	 
	Address
	 

H1032

ADDENDUM TO MEDICARE MANAGED CARE CONTRACT PURSUANT TO
SECTIONS 1860D-1 THROUGH 1860D-43 OF THE SOCIAL SECURITY ACT FOR
THE OPERATION OF A VOLUNTARY MEDICARE PRESCRIPTION DRUG PLAN
 
The Centers for Medicare & Medicaid Services (hereinafter referred to as "CMS") and WELLCARE OF FLORIDA, INC., a Medicare managed care organization (hereinafter referred to as MA-PD Sponsor) agree to amend the contract H1032 governing MA-PD Sponsor's operation of a Part C plan described in § 1851(a)(2)(A) of the Social Security Act (hereinafter referred to as "the Act") or a Medicare cost plan to include this addendum under which MA-PD Sponsor shall operate a Voluntary Medicare Prescription Drug Plan pursuant to §§1860D-1 through 1860D-43 (with the exception of §§1860D-22(a) and 1860D-31) of the Act.

This addendum is made pursuant to Subpart L of 42 CFR Part 417 (in the case of cost plan sponsors offering a Part D benefit) and Subpart K of 42 CFR Part 422 (in the case of an MA-PD Sponsor offering a Part C plan).

NOTE: For purposes of this addendum, unless otherwise noted, reference to an "MA-PD Sponsor" or "MA-PD Plan" is deemed to include a cost plan sponsor or a MA private fee-for-service contractor offering a Part D benefit.

Page  1 of 9
H1032

Article I 
Voluntary Medicare Prescription Drug Benefit
 
A.  MA-PD Sponsor agrees to operate one or more Medicare Voluntary Prescription Drug Plans as described in its application and related materials submitted to CMS for Medicare approval, including but not limited to all the attestations contained therein and all supplemental guidance, and in compliance with the provisions of this addendum, which incorporates in its entirety the Solicitation for Applications for Medicare Prescription Drug Plan 2015 Contracts, released on January 14, 2014 (hereinafter collectively referred to as "the addendum"). MA-PD Sponsor also agrees to operate in accordance with the regulations at 42 CFR Part 423 (with the exception of Subparts Q, R, and S), §§1860D-1 through 1860D-43 (with the exception of §§1860D-22(a) and 1860D-31) of the Act, and the applicable solicitation identified above, as well as all other applicable Federal statutes, regulations, and policies. This addendum is deemed to incorporate any changes that are required by statute to be implemented during the term of this contract and any regulations or policies implementing or interpreting such statutory or regulatory provisions.

B. CMS agrees to perform its obligations to MA-PD Sponsor consistent with the regulations at 42 CFR Part423 (with the exception of Subparts Q, R, and S), §§1860D-1 through 1860D-43 (with the exception of §§1860D-22(a) and 1860D-31) of the Act, and the applicable solicitation, as well as all other applicable Federal statutes, regulations, and policies.

C. CMS agrees that it will not implement, other than at the beginning of a calendar year, regulations under 42 CFR Part 423 that impose new, significant regulatory requirements on MA-PD Sponsor. This provision does not apply to new requirements mandated by statute.

D. If MA-PD Sponsor had an MA-PD Addendum with CMS for Contract Year 2014 under the contract ID number designated above, this document is considered a renewal of the existing addendum. While the terms of this document supersede the terms of the 2014 addendum, the parties' execution of this contract does not extinguish or interrupt any pending obligations or actions that may have arisen under the 2014 or prior year addendums.

E. This addendum is in no way intended to supersede or modify 42 CFR, Parts 417, 422 or 423. Failure to reference a regulatory requirement in this addendum does not affect the applicability of such requirements to MA-PD Sponsor and CMS.
 
Article II 
Functions to be Performed by MA-PD Sponsor
 
		
	A.
	ENROLLMENT

 
1.  MA-PD Sponsor agrees to enroll in its MA-PD plan only Part D-eligible beneficiaries as they are defined in 42 CFR §423.30(a) and who have elected to enroll in MA-PD Sponsor's Part C or §1876 benefit.

2. If MA-PD Sponsor is a cost plan sponsor, MA-PD Sponsor acknowledges that its §1876 plan enrollees are not required to elect enrollment in its Part D plan.
 
		
	B.
	PRESCRIPTION DRUG BENEFIT

 
1.  MA-PD Sponsor agrees to provide the required prescription drug coverage as defined under 42 CFR §423.100 and, to the extent applicable, supplemental benefits as defined in 42 CFR §423.100 and in accordance with Subpart C of 42 CFR Part 423. MA-PD Sponsor also agrees to provide Part D benefits as described in MA-PD Sponsor's Part D bid(s) approved each year by CMS (and in the Attestation of Benefit Plan and Price, attached hereto).

2. MA-PD Sponsor agrees to calculate and collect beneficiary Part D premiums in accordance with 42 CFR §§423.286 and 423.293.

Page  2 of 9
H1032

3. If MA-PD Sponsor is a cost plan sponsor, it acknowledges that its Part D benefit is offered as an optional supplemental service in accordance with 42 CFR §417.440(b)(2)(ii).
4.  PDP Sponsor agrees to maintain administrative and management capabilities sufficient for the organization to organize, implement, and control the financial, marketing, benefit administration, and quality assurance activities related to the delivery of Part D services as required by 42 CFR §423.505(b)(25).

5. PDP Sponsor agrees to provide applicable beneficiaries applicable discounts on applicable drugs in accordance with the requirements of 42 CFR Part 423 Subpart W.
 
		
	C.
	DISSEMINATION OF PLAN INFORMATION

1.  MA-PD Sponsor agrees to provide the information required in 42 CFR §423.48.

2. MA-PD Sponsor acknowledges that CMS releases to the public summary reconciled Part D Payment data after the reconciliation of Part D Payments for the contract year as provided in 42 CFR §423.505(o).

3. MA-PD Sponsor agrees to disclose information related to Part D benefits to beneficiaries in the manner and the form specified by CMS under 42 CFR §§423.128 and 423 Subpart V Marketing Requirements and in the Medicare Marketing Guidelines for Medicare Advantage-Prescription Drug Plans (MA-PDs) and Prescription Drug Plans (PDPs).

4. MA-PD Sponsor certifies that all materials it submits to CMS under the File and Use Certification authority described in the Medicare Marketing Guidelines are accurate, truthful, not misleading, and consistent with CMS marketing guidelines.
 
		
	D.
	QUALITY ASSURANCE/UTILIZATION MANAGEMENT

 
1.  MA-PD Sponsor agrees to operate quality assurance, drug utilization management, and medication therapy management programs, and to support electronic prescribing in accordance with Subpart D of 42 CFR Part 423.

2. MA-PD sponsor agrees to address complaints received by CMS against the Part D sponsor as required in 42 CFR §423.505(b)(22) by:

(a) Addressing and resolving complaints in the CMS complaint tracking system; and

(b) Displaying a link to the electronic complaint form on the Medicare.gov Internet Web site on the Part D plan's main Web page.

3.    PDP Sponsor agrees to maintain a Part D summary plan rating score of at least 3 stars as required by 42 CFR §423.505(b)(26).

		
	E.
	APPEALS AND GRIEVANCES

 
MA-PD Sponsor agrees to comply with all requirements in Subpart M of 42 CFR Part 423 governing coverage determinations, grievances and appeals, and formulary exceptions and the relevant provisions of Subpart U governing reopenings. MA-PD Sponsor acknowledges that these requirements are separate and distinct from the appeals and grievances requirements applicable to MA-PD Sponsor through the operation of its Part C or cost plan benefits.
 
		
	F.
	PAYMENT TO MA-PD SPONSOR

 
MA-PD Sponsor and CMS agree that payment paid for Part D services under the addendum will be governed by the rules in Subpart G of 42 CFR Part 423.
 
		
	G.
	BID SUBMISSION AND REVIEW

 
If MA-PD Sponsor intends to participate in the Part D program for the next program year, MA-PD Sponsor agrees to submit the next year's Part D bid, including all required information on premiums, benefits, and cost-sharing, by the applicable due date, as provided in Subpart F of 42 CFR Part 423 so that CMS and MA-PD Sponsor may conduct 

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negotiations regarding the terms and conditions of the proposed bid and benefit plan renewal. MA-PD Sponsor acknowledges that failure to submit a timely bid under this section may affect the sponsor's ability to offer a Part C plan, pursuant to the provisions of 42 CFR §422.4(c).
 H. COORDINATION WITH OTHER PRESCRIPTION DRUG COVERAGE
 
1.  MA-PD Sponsor agrees to comply with the coordination requirements with State Pharmacy Assistance Programs (SPAPs) and plans that provide other prescription drug coverage as described in Subpart J of 42 CFR Part 423.

2. MA-PD Sponsor agrees to comply with Medicare Secondary Payer procedures as stated in 42 CFR §423.462. 
 
		
	I.
	SERVICE AREA AND PHARMACY ACCESS

 
1.  MA-PD Sponsor agrees to provide Part D benefits in the service area for which it has been approved by CMS to offer Part C or cost plan benefits utilizing a pharmacy network and formulary approved by CMS that meet the requirements of 42 CFR §423.120.

2. MA-PD Sponsor agrees to provide Part D benefits through out-of-network pharmacies according to 42 CFR §423.124.

3. MA-PD Sponsor agrees to provide benefits by means of point-of-service systems to adjudicate prescription drug claims in a timely and efficient manner in compliance with CMS standards, except when necessary to provide access in underserved areas, I/T/U pharmacies (as defined in 42 CFR §423.100), and long-term care pharmacies (as defined in 42 CFR §423.100) according to 42 CFR §423.505(b)(17).

4. MA-PD Sponsor agrees to contract with any pharmacy that meets MA-PD Sponsor's reasonable and relevant standard terms and conditions according to 42 CFR §423.505(b)(18).

5. MA-PD Sponsor agrees to contract with any pharmacy that meets MA-PD Sponsor's reasonable and relevant standard terms and conditions. If MA-PD Sponsor has demonstrated that it historically fills 98% or more of its enrollees' prescriptions at pharmacies owned and operated by MA-PD Sponsor (or presents compelling circumstances that prevent the sponsor from meeting the 98% standard or demonstrates that its Part D plan design will enable the sponsor to meet the 98% standard during the contract year), this provision does not apply to MA-PD Sponsor's plan. 42 CFR§423.120(a)(7)(i)

6. The provisions of 42 CFR §423.120(a) concerning the retail pharmacy access standard do not apply to MA-PD Sponsor if the Sponsor has demonstrated to CMS that it historically fills more than 50% of its enrollees' prescriptions at pharmacies owned and operated by MA-PD Sponsor. MA-PD Sponsors excused from meeting the standard are required to demonstrate retail pharmacy access that meets the requirements of 42 CFR §422.112 for a Part C contractor and 42 CFR §417.416(e) for a cost plan contractor. 42 CFR§423.120(a)(7)(i)
 
		
	J.
	EFFECTIVE COMPLIANCE PROGRAM/PROGRAM INTEGRITY

 
MA-PD Sponsor agrees that it will develop and implement an effective compliance program that applies to its Part D-related operations, consistent with 42 CFR §423.504(b)(4)(vi).
 
		
	K.
	LOW-INCOME SUBSIDY

 
MA-PD Sponsor agrees that it will participate in the administration of subsidies for low-income subsidy eligible individuals according to Subpart P of 42 CFR Part 423.
 
		
	L.
	BENEFICIARY FINANCIAL PROTECTIONS

 
MA-PD Sponsor agrees to afford its enrollees protection from liability for payment of fees that are the obligation of MA-PD Sponsor in accordance with 42 CFR §423.505(g).
 
		
	M.
	RELATIONSHIP WITH FIRST TIER, DOWNSTREAM, AND RELATED ENTITIES

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 1.  MA-PD Sponsor agrees that it maintains ultimate responsibility for adhering to and otherwise fully complying with all terms and conditions of this addendum.

2.  MA-PD Sponsor shall ensure that any contracts or agreements with first tier, downstream, and related entities performing functions on MA-PD Sponsor's behalf related to the operation of the Part D benefit are in compliance with 42 CFR §423.505(i).
 
		
	N.
	CERTIFICATION OF DATA THAT DETERMINE PAYMENT

 
MA-PD Sponsor must provide certifications in accordance with 42 CFR §423.505(k). 
 
		
	O.
	MA-PD SPONSOR REIMBURSEMENT TO PHARMACIES

 
1.  If MA-PD Sponsor uses a standard for reimbursement of pharmacies based on the cost of a drug, MA-PD Sponsor will update such standard not less frequently than once every 7 days, beginning with an initial update on January 1 of each year, to accurately reflect the market price of the drug.

2. MA-PD Sponsor will issue, mail, or otherwise transmit payment with respect to all claims submitted by pharmacies (other than pharmacies that dispense drugs by mail order only, or are located in, or contract with, a long-term care facility) within 14 days of receipt of an electronically submitted claim or within 30 days of receipt of a claim submitted otherwise.

3. MA-PD Sponsor must ensure that a pharmacy located in, or having a contract with, a long-term care facility will have not less than 30 days (but not more than 90 days) to submit claims to MA-PD Sponsor for reimbursement.
 
Article III 
Record Retention and Reporting Requirements
 
		
	A.
	RECORD MAINTENANCE AND ACCESS

 
MA-PD Sponsor agrees to maintain records and provide access in accordance with 42 CFR §§ 423.505 (b)(10) and 423.505(i)(2).
 
		
	B.
	GENERAL REPORTING REQUIREMENTS

 
MA-PD Sponsor agrees to submit information to CMS according to 42 CFR §§423.505(f) and 423.514, and the "Final Medicare Part D Reporting Requirements," a document issued by CMS and subject to modification each program year.
 
		
	C.
	CMS LICENSE FOR USE OF PLAN FORMULARY

 
MA-PD Sponsor agrees to submit to CMS each plan's formulary information, including any changes to its formularies, and hereby grants to the Government, and any person or entity who might receive the formulary from the Government, a non-exclusive license to use all or any portion of the formulary for any purpose related to the administration of the Part D program, including without limitation publicly distributing, displaying, publishing or reconfiguration of the information in any medium, including www.medicare.gov, and by any electronic, print or other means of distribution.

Article IV 
HIPAA Provisions
 
A.  MA-PD Sponsor agrees to comply with the confidentiality and enrollee record accuracy requirements specified in 42 CFR §423.136.

B. MA-PD Sponsor agrees to enter into a business associate agreement with the entity with which CMS has contracted to track Medicare beneficiaries' true out-of-pocket costs.
 
Article V 
Addendum Term and Renewal
 
		
	A.
	TERM OF ADDENDUM

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This addendum is effective from the date of CMS' authorized representative's signature through December 31, 2015. This addendum shall be renewable for successive one-year periods thereafter according to 42 CFR §423.506.
 
B.  QUALIFICATION TO RENEW ADDENDUM
 
 1.  In accordance with 42 CFR §423.507, MA-PD Sponsor will be determined qualified to renew this addendum annually only if—
 
(a) MA-PD Sponsor has not provided CMS with a notice of intention not to renew in accordance with Article VII of this addendum, and

(b) CMS has not provided MA-PD Sponsor with a notice of intention not to renew.

2.  Although MA-PD Sponsor may be determined qualified to renew its addendum under this Article, if MA-PD Sponsor and CMS cannot reach agreement on the Part D bid under Subpart F of 42 CFR Part 423, no renewal takes place, and the failure to reach agreement is not subject to the appeals provisions in Subpart N of 42 CFR Parts 422 or 423. (Refer to Article X for consequences of non-renewal on the Part C contract and the ability to enter into a Part C contract.)
 
Article VI 
Nonrenewal of Addendum

		
	A.
	NONRENEWAL BY MA-PD SPONSOR

 
1.  MA-PD Sponsor may non-renew this addendum in accordance with 42 CFR 423.507(a).

2. If MA-PD Sponsor non-renews this addendum under this Article, CMS cannot enter into a Part D addendum with the organization or with an organization whose covered persons, as defined in 42 CFR §423.507(a)(4), also served as covered persons for the nonrenewing sponsor for 2 years unless there are special circumstances that warrant special consideration, as determined by CMS.
 
B.  NONRENEWAL BY CMS
 
CMS may non-renew this addendum under the rules of 42 CFR 423.507(b). (Refer to Article X for consequences of non-renewal on the Part C contract and the ability to enter into a Part C contract.)
 
Article VII 
Modification or Termination of Addendum by Mutual Consent
 
This addendum may be modified or terminated at any time by written mutual consent in accordance with 42 CFR 423.508. (Refer to Article X for consequences of non-renewal on the Part C contract and the ability to enter into a Part C contract.)
 Article VIII 
Termination of Addendum by CMS
 
CMS may terminate this addendum in accordance with 42 CFR 423.509. (Refer to Article X for consequences of non-renewal on the Part C contract and the ability to enter into a Part C contract.)
 
Article IX 
Termination of Addendum by MA-PD Sponsor
 
A.  MA-PD Sponsor may terminate this addendum only in accordance with 42 CFR 423.510.

B. CMS will not enter into a Part D addendum with an MA-PD Sponsor that has terminated its addendum or with an organization whose covered persons, as defined in 42 CFR §423.508(f), also served as covered persons for the 

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terminating sponsor within the preceding 2 years unless there are circumstances that warrant special consideration, as determined by CMS.
 C.  If the addendum is terminated under section A of this Article, MA-PD Sponsor must ensure the timely transfer of any data or files. (Refer to Article X for consequences of non-renewal on the Part C contract and the ability to enter into a Part C contract.)

 Article X 
Relationship between Addendum and Part C Contract or 1876 Cost Contract
 
A.  MA-PD Sponsor acknowledges that, if it is a Medicare Part C contractor, the termination or nonrenewal of this addendum by either party may require CMS to terminate or non-renew the Sponsor's Part C contract in the event that such non-renewal or termination prevents MA-PD Sponsor from meeting the requirements of 42 CFR §422.4(c), in which case the Sponsor must provide the notices specified in this contract, as well as the notices specified under Subpart K of 42 CFR Part 422. MA-PD Sponsor also acknowledges that Article IX.B. of this addendum may prevent the sponsor from entering into a Part C contract for two years following an addendum termination or non-renewal where such non-renewal or termination prevents MA-PD Sponsor from meeting the requirements of 42 CFR §422.4(c).

B. The termination of this addendum by either party shall not, by itself, relieve the parties from their obligations under the Part C or cost plan contracts to which this document is an addendum.

C. In the event that MA-PD Sponsor's Part C or cost plan contract (as applicable) is terminated or nonrenewed by either party, the provisions of this addendum shall also terminate. In such an event, MA-PD Sponsor and CMS shall provide notice to enrollees and the public as described in this contract as well as 42 CFR Part 422, Subpart K or 42 CFR Part 417, Subpart K, as applicable.
 
Article XI 
Intermediate Sanctions
 
Consistent with Subpart O of 42 CFR Part 423, MA-PD Sponsor shall be subject to sanctions and civil money penalties.
 
Article XII 
Severability
 
Severability of the addendum shall be in accordance with 42 CFR §423.504(e).
 
Article XIII 
Miscellaneous
 
A.  DEFINITIONS

Terms not otherwise defined in this addendum shall have the meaning given such terms at 42 CFR Part 423 or, as applicable, 42 CFR Part 422 or Part 417.
 
B.  ALTERATION TO ORIGINAL ADDENDUM TERMS

MA-PD Sponsor agrees that it has not altered in any way the terms of the MA-PD addendum presented for signature by CMS. MA-PD Sponsor agrees that any alterations to the original text MA-PD Sponsor may make to this addendum shall not be binding on the parties.
 
C.  ADDITIONAL CONTRACT TERMS

MA-PD Sponsor agrees to include in this addendum other terms and conditions in accordance with 42 CFR §423.505(j).
 D.  CMS APPROVAL TO BEGIN MARKETING AND ENROLLMENT ACTIVITIES

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MA-PD Sponsor agrees that it must complete CMS operational requirements related to its Part D benefit prior to receiving CMS approval to begin MA-PD plan marketing activities relating to its Part D benefit. Such activities include, but are not limited to, establishing and successfully testing connectivity with CMS systems to process enrollment applications (or contracting with an entity qualified to perform such functions on MA-PD Sponsor's behalf) and successfully demonstrating the capability to submit accurate and timely price comparison data. To establish and successfully test connectivity, MA-PD Sponsor must, 1) establish and test physical connectivity to the CMS data center, 2) acquire user identifications and passwords, 3) receive, store, and maintain data necessary to perform enrollments and send and receive transactions to and from CMS, and 4) check and receive transaction status information.

E. Pursuant to §13112 of the American Recovery and Reinvestment Act of 2009 (ARRA), MA-PD Sponsor agrees that as it implements, acquires, or upgrades its health information technology systems, it shall utilize, where available, health information technology systems and products that meet standards and implementation specifications adopted under § 3004 of the Public Health Service Act, as amended by §13101 of the ARRA.

F. MA-PD sponsor agrees to maintain a fiscally sound operation by at least maintaining a positive net worth (total assets exceed total liabilities) as required in 42 CFR §423.505(b)(23).

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In witness whereof, the parties hereby execute this contract.

 
This document has been electronically signed by:

 
FOR THE MA ORGANIZATION

	
				
	/s/ THOMAS TRAN
	 
	 
	 

	 
	 
	 
	 

	Contracting Official Name
	 
	 
	 

	
				
	8/28/2014 2:13:35 PM
	 
	 
	 

	 
	 
	 
	 

	Date
	 
	 
	 

	
				
	 
	 
	8735 Henderson Road
	 

	WELLCARE OF FLORIDA, INC.
	 
	TAMPA, FL 33634
	 

	 
	 
	 
	 

	Organization
	 
	Address
	 

FOR THE CENTERS FOR MEDICARE & MEDICAID SERVICES

	
				
	/s/ Amy K. Larrick
	 
	9/11/2014 1:10:21 PM
	 

	 
	 
	 
	 

	Amy K. Larrick
	 
	Date
	 

     Acting Director
Medicare Drug Benefit
and C & D Data Group,
Center for Medicare

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DATA USE ATTESTATION
 
The sponsor shall restrict its use and disclosure of Medicare data obtained from CMS information systems (listed in Attachment A) to those purposes directly related to the administration of the Medicare managed care and/or outpatient prescription drug benefits for which it has contracted with the Centers for Medicare & Medicaid Services (CMS) to administer. The sponsor shall only maintain data obtained from CMS information systems that are needed to administer the Medicare managed care and/or outpatient prescription drug benefits that it has contracted with CMS to administer. The sponsor (or its subcontractors or other related entities) may not re-use or provide other entities access to the CMS information system, or data obtained from the system, to support any line of business other than the Medicare managed care and/or outpatient prescription drug benefit for which the sponsor contracted with CMS.

The sponsor further attests that it shall limit the use of information it obtains from its Medicare plan members to those purposes directly related to the administration of such plan. The sponsor acknowledges two exceptions to this limitation. First, the sponsor may provide its Medicare members information about non-health related services after obtaining consent from the members. Second, the sponsor may provide information about health-related services without obtaining prior member consent, as long as the sponsor affords the member an opportunity to elect not to receive such information.

CMS may terminate the sponsor's access to the CMS data systems immediately upon determining that the sponsor has used its access to a data system, data obtained from such systems, or data supplied by its Medicare members beyond the scope for which CMS has authorized under this agreement. A termination of this data use agreement may result in CMS terminating the sponsor's Medicare contract(s) on the basis that it is no longer qualified as a Medicare sponsor. This agreement shall remain in effect as long as the sponsor remains a Medicare managed care organization and/or outpatient prescription drug benefit sponsor. This agreement excludes any public use files or other publicly available reports or files that CMS makes available to the general public on our website.

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Attachment A
 
The following list contains a representative (but not comprehensive) list of CMS information systems to which the Data Use Attestation applies. CMS will update the list periodically as necessary to reflect changes in the agency's information systems
 
Automated Plan Payment System (APPS)
Common Medicare Environment (CME)
Common Working File (CWF)
Coordination of Benefits Contractor (COBC)
Drug Data Processing System (DDPS)
Electronic Correspondence Referral System (ECRS)
Enrollment Database (EDB)
Financial Accounting and Control System (FACS)
Front End Risk Adjustment System (FERAS)
Health Plan Management System (HPMS), including Complaints Tracking and all other modules
HI Master Record (HIMR)
Individuals Authorized Access to CMS Computer Services (IACS)
Integrated User Interface (IUI)
Medicare Advantage Prescription Drug System (MARx)
Medicare Appeals System (MAS)
Medicare Beneficiary Database (MBD)
Payment Reconciliation System (PRS)
Premium Withholding System (PWS)
Prescription Drug Event Front End System (PDFS)
Retiree Drug System (RDS)
Risk Adjustments Processing Systems (RAPS)

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This document has been electronically signed by:

	
				
	/s/ THOMAS TRAN
	 
	 
	 

	 
	 
	 
	 

	Contracting Official Name
	 
	 
	 

	
				
	8/28/2014 2:13:35 PM
	 
	 
	 

	 
	 
	 
	 

	Date
	 
	 
	 

	
				
	WELLCARE OF FLORIDA, INC.
	 
	 
	 

	 
	 
	 
	 

	Organization
	 
	 
	 

	
				
	8735 Henderson Road
	 
	 
	 

	TAMPA, FL 33634
	 
	 
	 

	 
	 
	 
	 

	Address
	 
	 
	 

Page 3 of 3
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SIGNATURE ATTESTATION

 
Contract ID: H1032
Contract Name: WELLCARE OF FLORIDA, INC
 

I understand that by signing and dating this form, I am acknowledging that I am an authorized representative of the above named organization and that I am the contracting official associated with the user ID used to log on to the Health Plan Management System (HPMS) to sign the 2015 Medicare contracting documents. I also acknowledge that in accordance with the HPMS Rule of Behavior, sharing user IDs is strictly prohibited.
 
This document has been electronically signed by:
 
 
	
				
	/s/ THOMAS TRAN
	 
	 
	 

	 
	 
	 
	 

	Contracting Official Name
	 
	 
	 

	
				
	8/28/2014 2:13:35 PM
	 
	 
	 

	 
	 
	 
	 

	Date
	 
	 
	 

	
				
	WELLCARE OF FLORIDA, INC.
	 
	 
	 

	 
	 
	 
	 

	Organization
	 
	 
	 

	
				
	8735 Henderson Road
	 
	 
	 

	TAMPA, FL 33634
	 
	 
	 

	 
	 
	 
	 

	Address
	 
	 
	 

H1032Exhibit
10.1

 

EMPLOYMENT
AGREEMENT

 

This
Employment Agreement ("Agreement") is made and entered into as of the 21st day of April, 2014, by and
between MobileBits Corporation, a Florida corporation (the "Employer" or the Company"), and
Hussein Abu Hassan (the "Employee").

 

WITNESSETH:

 

1.           Employment. The Employer hereby employs the Employee, and the Employee hereby accepts such employment, upon the terms and
subject to the conditions set forth in this Agreement.

 

2.           Term. Subject to the provisions of termination as hereinafter provided, the term of employment under this Agreement shall
commence April 21, 2014 (the "Commencement Date") and shall continue through the end of the business day, April
21, 2017; provided, however, that beginning on April 21, 2017 and on the first calendar day after the conclusion of any term of
this Agreement (each a "Renewal Date") thereafter, the term of this Agreement shall automatically be extended
for one additional years, unless either party gives the other written notice of non-renewal at least ten (10) days prior to any
such Renewal Date. The "term of this Agreement" shall mean period of time beginning as of the Commencement Date and
ending as of the last date that the Employee is employed by the Company.

 

3.           Compensation; Reimbursement, Etc.

 

(a)  
        Basic Salary. The Employer shall pay to the Employee as compensation for all services rendered
by the Employee during the term of this Agreement a basic annualized salary of $120,000.00 per year (the "Basic Salary"),
or such greater sum as the parties may agree on from time to time, payable monthly on the first day of each month during the term
of this Agreement. The Board of Directors of the Employer and the Employee shall review and discuss the Basic Salary of the Employee
and the Employee shall be entitled to an increase to such Basic Salary as mutually agreed between them. In addition, the Board
of Directors of the Employer, in its discretion, may, with respect to any year during the term hereof, award a bonus or bonuses
to the Employee in addition to the bonuses provided for in Section 3(b). The compensation provided for in this Section 3(a) shall
be in addition to any pension or profit sharing payments set aside or allocated for the benefit of the Employee.

 

(b)
           Bonus. In addition to the Basic Salary paid pursuant to Section 3(a), the Employer
shall pay as incentive compensation an annual bonus based upon the Employee's performance and computed in accordance with an incentive
management bonus plan that is each year recommended and/or approved by the Board of Directors of the Employer. The Employee's
participation in such incentive management bonus plan shall be on the basis and terms as recommended and/or approved by the Board
of Directors of the Employer. For each bonus period during the term of this Agreement the minimum bonus shall be equal to 100%
of the Employee's Basic Salary during such bonus period. In no event shall the bonus paid to the Employee for any twelve (12)
month period under this Agreement in which Employee remains employed during the entire twelve (12) month period be less than $120,000
and the Employee shall be entitled to a guaranteed bonus of such amount. 

 

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(c)           Stock
Options. Effective as of the Commencement Date, the Employee shall receive one or more nonqualified stock options to purchase
an aggregate of Twelve Million (12,000,000) shares of the Employer's common stock. The right to purchase such stock shall be nontransferable
and shall vest immediately upon the Commencement Date. The options shall have a term of seven (7) years and the exercise price
of the options shall be equal to the fair market value of the stock on the date of grant which the parties mutually agree is $0.05.
The Employer may grant said stock options either under the Employer's currently existing stock option plans ("Plans"),
or in such other manner as may be determined by the Employer; provided, however, that the terms pursuant to which the stock option
is granted, if granted outside of the Plans, shall be substantially similar to the terms of grant contained in the Plans, and
further provided, that in any case, the shares of common stock underlying the options shall be registered on Form S-8 (or an equivalent
registration statement). During the Employment Term, the Employee shall also be eligible to receive additional stock options as
determined by the Board in accordance with the Employer's practices applicable to senior employees of the Employer.

 

(d)            Tax-Gross
Up Payments. In addition to such other amounts as are due and payable under this Agreement, the Company shall make such
additional payments to Employee as are necessary to provide Employee with enough funds to pay any and all taxes attributable
to or resulting from the payment of the Basic Salary, the bonus and any other compensation paid to Employee under this
Agreement, including without limitation to any and all income tax arising under the Internal Revenue Code, and state,
Canadian and provincial laws with the end result that Employee shall receive the Basic Salary and Bonuses as if no such tax
was applicable to the Employee. The Company shall make any payments required by this paragraph no later than 105 days after
the last day of Employee's taxable year following the Employee's taxable year in which the applicable Basic Salary and
Bonuses are paid to the Employee.

 

(e)      
     Benefits and Perquisites. During the term of this Agreement, Employee shall be provided with the standard health insurance,
disability insurance and such other benefits as may be offered by the Company to executive level employees.

 

(f)           
Reimbursements. The Employer shall reimburse the Employee for all reasonable expenses incurred by the Employee in
the performance of his duties under this Agreement including without limitation all travel expenses related to his duties on behalf
of the Company; provided, however, that the Employee must furnish to the Employer an itemized account, satisfactory to the Employer,
in substantiation of such expenditures. In addition, Employer shall pay, or reimburse Employee for, all membership fees and related
costs in connection with Employee's membership in professional and civic organizations which are approved in advance by the Employer.

 

4.         Duties.
The Employee is engaged as President. Subject to the direction and supervision of the Employer's Board of Directors,
the Employee shall perform such duties as are customarily associated with a President of a Florida corporation.

 

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5.          Extent
of Services; Vacations and Days Off. 

 

(a)            During
the term of his employment under this Agreement, the Employee shall devote such time, energy and attention during regular business
hours to the benefit and business of the Employer as may be reasonably necessary in performing his duties pursuant to this Agreement.

 

(b)            The
Employee shall be entitled to at least six weeks of vacation per year with pay and to such personal and sick leave with pay in
accordance with the policy of the Employer as may be established from time to time by the Employer and applied to other senior
employees of the Employer. In addition, the Employee shall be entitled to such fringe benefits as may be provided from time to
time by the Employer to other executives of the Employer or its affiliates.

 

6.           Indemnification.
The Employer shall indemnify the Employee to the fullest extent that would be permitted by law as in effect at the time of
the subject act or omission, or by the Articles of Incorporation and Bylaws of the Employer as in effect at such time, or by the
terms of any indemnification agreement between the Employer and the Employee, whichever affords greatest protection to the Employee,
and the Employee shall be entitled to the protection of any insurance policies the Employer may elect to maintain generally for
the benefit of its employees (and to the extent the Employer maintains such an insurance policy or policies, in accordance with
its or their terms to the maximum extent of the coverage available for any company employee), against any and all loss, claim,
damage, liability, deficiencies, actions, suits, proceedings, claims, costs and legal expenses or expense whatsoever (including,
but not limited to, reasonable legal fees and other expenses and reasonable disbursements incurred in connection with investigating,
preparing to defend or defending any action, suit or proceeding, including any inquiry or investigation, commenced or threatened,
or any claim whatsoever, or in appearing or preparing for appearance as witness in any proceeding, including any pretrial proceeding
such as a deposition) at the time such costs, charges and expenses are incurred or sustained, in connection with any action, claim,
suit or proceeding to which the Employee may be made a party by reason of his being or having been an employee of the Employer,
or serving as an employee of an Affiliate of the Employer, other than any action, suit or proceeding brought against the Employee
by or on account of his breach of the provisions of any employment agreement with a third party that has not been disclosed by
the Employee to the Employer. Notwithstanding the foregoing, Employee shall not be entitled to indemnification pursuant to this
paragraph 6 to the extent that any such liability is found in a final judgment by a court of competent jurisdiction to have resulted
primarily and directly from the Employee's fraud, gross negligence
or willful misconduct. The Company shall advance all Expenses incurred by the Employee in connection with the investigation, defense,
settlement or appeal of any Proceeding to which the Employee is a party or is threatened to be made a party by reason of the fact
that the Employee is or was an Agent of the Company (including services as an Agent of an Affiliate). The Employee hereby undertakes
to repay such amounts advanced only if, and to the extent that, it shall be determined ultimately that the Employee is not entitled
to be indemnified by the Company as authorized hereby. The advances to be made hereunder shall be paid by the Company to the Employee
within twenty (20) days following delivery of a written request therefor by the Employee to the Company. In the event that the
Company takes the position that Employee is not entitled to indemnification in connection with the proposed settlement of any Proceeding,
Employee shall have the right at his own expense to undertake defense of any such claim, insofar as such Proceeding involves claims
against the Employee, by written notice given to the Company within 10 days after the Company has notified Employee in writing
of its contention that Employee is not entitled to indemnification; provided, however, that the failure to give
such notice within such 10-day period shall not affect or limit the Company's obligations with respect to advancement and indemnification
under this Agreement. For purposes of this Agreement, "Expenses" shall mean all out-of-pocket costs of any type or nature
whatsoever (including, without limitation, all attorneys' fees and related disbursements), actually and reasonably incurred by
the Employee in connection with either the investigation, defense or appeal of a Proceeding or establishing or enforcing a right
to indemnification under this Agreement or otherwise. Any payments to be made to Employee pursuant to this Section 6 shall first
be made under insurance policies that the Employer may maintain generally for the benefit of its employees, if any. An "Affiliate"
shall mean any entity controlling, controlled by or under common control with Employer. The provisions of this Section 6 shall
specifically survive the expiration or earlier termination of this Agreement. Shall any portion of this Section 6 be held to be
invalid, unreasonable, and arbitrary or against public policy, then such portion of the paragraph shall be modified to provide
Employee with the fullest protection that would be permitted by law. 

 

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7.           Terminations.

 

(a)            Voluntary
Termination by Employee. The Employee may terminate his employment hereunder upon giving at least ten (10) business days'
prior written notice. If the Employee gives notice pursuant to Section 7(a) above, the Employer shall have the right to relieve
the Employee, in whole or in part, of his duties under this Agreement (without reduction in compensation through the termination
date).

 

(b)            Termination
By Employee for Good Reason. The Employee may terminate his employment hereunder for Good Reason and upon written notice.
As used herein, "Good Reason" shall include the following:

 

    (i)           Should
the Company materially breach its duties as specified in this
Agreement; or

 

   (ii)           Mobile
Bits Holding Corporation fails to elect Employee to its Board of Directors or Mobile Bits Holding Corporation relieves Employee
of his position as the member of the Board of Directors of the Company for reasons other than for "Good Cause" (as such
term is defined in Section 7(c) of this Agreement).

 

If
the Employee shall terminate this Agreement with Good Reason, effective on a date earlier than a Renewal Date as provided for
in Section 2 (with the effective date of termination as so identified by the Employer's Board of Directors upon receipt of written
notice from Employee of his termination with Good Reason being referred to herein as the "Accelerated Termination Date"),
the Employee, until the date which is twelve (12) month(s) after the Accelerated Termination Date, shall continue to receive the
Basic Salary and other compensation and employee benefits (including without limitation the bonus that would otherwise have been
payable during such compensation continuation period under the bonus plan in effect immediately
before the Accelerated Termination Date) that the Employer has heretofore in Section 3 agreed to pay and to provide for the Employee,
in each case in the amount and kind and at the time provided for in Section 3; provided that, notwithstanding such termination
of employment, the Employee's covenants set forth in Section 9 and Section 10 are intended to and shall remain in full force and
effect. The parties agree that, because there can be no exact measure of the damage that would occur to the Employee as a result
of terminating his employment for Good Reason, the payments and benefits paid and provided pursuant to this Section 9(b) shall
be deemed to constitute liquidated damages and not a penalty for the termination of the Employee's employment with Good Reason,
and the Employer agrees that the Employee shall not be required to mitigate his damages,

 

    	4 | Page

    	 

    

 

(c)           Termination
by Employer.Except as otherwise provided in this Agreement, the Employer may terminate the employment of the Employee
hereunder only for Good Cause upon written notice; provided, however, that no breach or default by the Employee shall be deemed
to occur hereunder unless the Employee shall have failed to cure the breach or default within thirty (30) days after Employee
received written notice thereof indicating that it is a notice of termination pursuant to this Section of this Agreement. As used
herein, "Good Cause" shall include:

 

(i)            
 the Employee's conviction of either a felony involving moral turpitude or any crime in connection with his employment
by the Employer which causes the Employer a substantial detriment, but specifically shall not include traffic
offenses;

 

(ii)             willful
or material wrongdoing by the Employee, including, but not limited to, acts of fraud, which could be expected to have a materially
adverse effect, monetarily or otherwise, on the Employer or its subsidiaries or affiliates, as determined by the Employer and
its Board of Directors;

 

(iii)            material
breach by the Employee of a material obligation under this Agreement or of his duty to the Employer; or

 

(iv)           any
condition which either resulted from the Employee's substantial dependence, as reasonably determined by the Board of Directors
of the Employer, on alcohol, or any narcotic drug or other controlled or illegal substance. If any determination of substantial
dependence is disputed by the Employee, the parties hereto agree to abide by the decision of a panel of three physicians appointed
in the manner and subject to the same penalties for noncompliance as specified in Section 7(c) of this Agreement.

 

Termination
of the employment of the Employee for reasons other than those expressly specified in this Agreement as good cause shall be deemed
to be a termination of employment "without Good Cause." If the Employer shall terminate the employment of the Employee
without good cause, effective on a date earlier than a Renewal Date as provided for in Section 2 (with the effective date of termination
as so identified by the Employer being referred to herein as the "Accelerated Termination Date"), the Employee,
shall continue to receive the Basic Salary and other compensation and employee benefits for three months (including without limitation
the bonus that would otherwise have been payable during such compensation continuation period under the bonus plan in effect immediately
before the Accelerated Termination Date) that the Employer
has heretofore in Section 3 agreed to pay and to provide for the Employee, in each case in the amount and kind and at the time
provided for in Section 3; provided that, notwithstanding such termination of employment, the Employee's covenants set forth in
Section 9 and Section 10 are intended to and shall remain in full force and effect. The parties agree that, because there can
be no exact measure of the damage that would occur• to the Employee as a result of a termination by the Employer of the Employee's
employment without good cause, the payments and benefits paid and provided pursuant to this Section 9(d) shall be deemed to constitute
liquidated damages and not a penalty for the Employer's termination of the Employee's employment without good cause, and the Employer
agrees that the Employee shall not be required to mitigate his damages.

 

    	5 | Page

    	 

    

 

(d)          
Termination on Death. If the Employee dies during the term of his employment, the Employer shall pay to the estate of the
Employee such compensation, including any bonus compensation earned but not yet paid, as would otherwise have been payable to
the Employee up to the end of the month in which his death occurs including all of the Employee's stock options.

 

(e)         
Disability, Illness and Incapacity. During any period of disability, illness or incapacity
during the term of this Agreement which renders the Employee at least temporarily unable to perform the services required under
this Agreement for a period which shall not equal or exceed (1) a period of 120 consecutive days or (2) shorter periods aggregating
180 days during any twelve-month period, the Employee shall receive the compensation payable under Section 3 of this Agreement
plus any bonus compensation earned but not yet paid, less any benefits received by him/her under any disability insurance carried
by or provided by the Employer. All rights of the Employee under this Agreement (other than rights already accrued) shall
terminate as provided below upon the Employee's permanent disability (as defined below), although the Employee shall continue
to receive any disability benefits to which he may be entitled under any disability income insurance which may be carried
by or provided by the Employer from time to time. The term "permanent disability" as used in this Agreement shall mean
the inability of the Employee, as determined by the Board of Directors of the Employer, by reason of physical or mental disability
to perform the duties required of him under this Agreement for (1) a period of 120 consecutive days or (2) shorter periods aggregating
180 days during any twelve-month period. Successive periods of disability, illness or incapacity will be considered separate
periods unless the later period of disability, illness or incapacity is clue to the same or related cause and commences
less than six months from the ending of the previous period of disability. Upon such determination, the Board of Directors may
terminate the Employee's employment under this Agreement upon ten (10) days' prior written notice. If any determination of the
Board of Directors with respect to permanent disability is disputed by the Employee, the parties hereto agree to abide by the
decision of a panel of three physicians. The Employee and Employer shall each appoint one member, and the third member of the
panel shall be appointed by the other two members. The Employee agrees to make himself available for and submit to examinations
by such physicians as may be directed by the Employer. Failure to submit to any such examination shall constitute a breach of
a material part of this Agreement.

 

    	6 | Page

    	 

    

 

8.           Disclosure.
The Employee agrees that during the term of Employee's employment by
the Employer, Employee will disclose and disclose only to the Employer, in writing, all ideas, methods, plans, developments or
improvements known by his which relate directly or indirectly to
the business of the Employer, whether acquired by the Employee before or during Employee's employment by the Employer. Nothing
in this Section 8 shall be construed as requiring any such communication where the idea, plan, method or development is lawfully
protected from disclosure as a trade secret of a third party or by any other lawful prohibition against such communication.

 

9.           Confidentiality
and Ownership Rights.

 

      (a)           
Nondisclosure of Information. The Employee acknowledges that in the course of Employee's employment by the Employer Employee
will receive certain trade secrets, which may include, but are not limited to, programs, lists of acquisition or disposition prospects
and knowledge of acquisition strategy, financial information and reports, lists of customers or potential customers and other
proprietary information, confidential information and knowledge concerning the business of the Employer (hereinafter collectively
referred to as "Information") which the Employer desires to protect. The Employee understands that the Information is
confidential and agrees not to reveal the Information to anyone outside the Employer, unless compelled to do so by any federal
or state regulatory agency or by a court order. If Employee becomes aware that disclosure of any Information is being sought by
such an agency or through a court order, Employee will immediately notify the Employer. The Employee further agrees that she will
at no time use the Information in competing with the Employer. Upon termination of Employee's employment with the Employer, regardless
of the reason for such termination, the Employee shall surrender to the Employer all papers, documents, writings and other property
produced by Employee or coming into Employee's possession by or through Employee's employment or relating to the Information,
and the Employee agrees that all such materials are and will at all times remain the property of the Employer and to the extent
the Employee has any rights therein, Employee hereby irrevocably assigns such rights to the Employer.

 

      (b)          
Ownership of Information, Ideas, Concepts, Improvements, Discoveries
and Inventions.

 

                (i)             All information, ideas, concepts, improvements, discoveries and inventions, whether patentable or not, which are conceived, made,
developed or acquired by Employee or which are disclosed or made known to Employee, individually or in conjunction with others,
during Employee's employment by the Employer and which relate to the Employer's business, products or services (including but
not limited to all such information relating to corporate opportunities, research, financial and sales data, pricing and trading
terms, evaluations, opinions, interpretations, acquisition prospects, the identity of customers or their requirements, the identity
of key contacts within the customer's organization or within the organization of acquisition prospects, or marketing and merchandising
techniques, prospective names and marks), are and shall be the sole and exclusive property of the Employer. Moreover, all drawings,
memoranda, notes, records, files, correspondence, manuals, models, specifications, computer programs, maps and all other writings
or materials of any type embodying any of such information, ideas, concepts, improvements, discoveries and inventions are and
shall be the sole and exclusive property of the Employer.

 

    	7 | Page

    	 

    

 

                (ii)             In particular, Employee hereby specifically sells, assigns and transfers to the Employer all of Employee's worldwide right, title
and interest in and to all such information, ideas, concepts, improvements, discoveries or inventions described in Section 9(b)(i)
above, and any United States or foreign applications for patents, inventor's certificates or other industrial rights that may
be filed thereon, including divisions, continuations, continuations-in-part, reissues and/or extensions thereof, and applications
for registration of such names and marks. Both during the period of Employee's employment by the Employer and thereafter, Employee
shall assist the Employer and its nominees at all times in the protection of such information, ideas, concepts, improvements,
discoveries or inventions both in the United States and all foreign countries, including but not limited to the execution of all
lawful oaths and all assignment documents requested by the Employer or its nominee in connection with the preparation, prosecution,
issuance or enforcement of any applications for United States or foreign letters patent, including divisions, continuations, continuations-in-part,
reissues, and/or extensions thereof, and any application for the registration of such names and marks.

 

(c)            The
provisions of this Section 9 shall specifically survive the expiration or earlier termination of this Agreement.

 

10.         Expenses. Employer shall pay or reimburse Employee for all reasonable out-of-pocket costs and expenses (including reasonable
fees and disbursements of legal counsel, appraisers, accountants and other experts employed or retained by Employee) incurred
by Employee in connection with, arising out of, or in any way related to the negotiation, preparation, execution and delivery
of this Agreement.

 

11.         Specific Performance. The Employee agrees that damages at law will be an insufficient remedy to the Employer if the Employee
violates the terms of Sections 8 and 9 of this Agreement and that the Employer would suffer irreparable damage as a result of
such violation. Accordingly, it is agreed that the Employer shall be entitled, upon application to a court of competent jurisdiction,
to obtain injunctive relief to enforce the provisions of such Sections, which injunctive relief shall be in addition to any other
rights or remedies available to the Employer. The provisions of this Section 11 shall specifically survive the expiration or earlier
termination of this Agreement.

 

12.         Compliance with Other Agreements. The Employee represents and warrants that the execution of this Agreement by Employee
and Employee's performance of Employee's obligations hereunder will not conflict with, result in the breach of any provision of
or the termination of or constitute a default under any Agreement to which the Employee is a party or by which the Employee is
or may be bound.

 

13.         Compliance with Tax Laws.

 

        (a)            If
any payment or benefit provided by Company to or for the benefit of the Employee,
whether paid or payable or distributed or distributable pursuant to the terms of this Agreement or otherwise, including, by example
and not by way of limitation, acceleration by the Company or otherwise of the date of payment under any plan, program, arrangement
or agreement of Company (a  “Payment") is subject to the excise tax imposed by Code section 4999 or any
interest or penalties with respect to such excise tax (the "Excise Tax"), then Company shall make such additional
payments to Employee (the "Excise Tax Gross Up Payments") as are necessary to provide Employee with enough funds
to pay the Excise Tax, as well as any additional taxes (other
than the 409A Tax, as defined below), including but not limited to additional Excise Tax, attributable to or resulting from the
payment of the Excise Tax Gross Up Payments, with the end result that Employee shall be in the same position with respect to his
tax liability (other than the 409A Tax) as he would have been in if no Excise Tax had ever been imposed. The Company shall make
any payments required by this paragraph no later than the last day of Employee's taxable year next following the Employee's taxable
year in which the Excise Tax is remitted to the taxing authority.

 

    	8 | Page

    	 

    

 

(b)       If
any Payment provided to Employee is subject to adverse tax consequences under Code section 409A, then Company shall make
such additional payments to Employee (the "409A Gross Up Payments") as are necessary to provide Employee with
enough funds to pay the additional taxes, interest, and penalties imposed by Code section 409A (collectively, the "409A
Tax"), as well as any additional taxes, including but not limited to additional 409A Tax, attributable to or resulting
from the payment of the 409A Gross Up Payments, with the end result that Employee shall be in the same position with respect to
his tax liability as he would have been in if no 409A Tax had ever been imposed. The Company shall make any payments required
by this paragraph no later than the last day of Employee's taxable year next following the Employee's taxable year in which the
409A Tax is remitted to the taxing authority.

 

13.         Waiver of Breach. The waiver by the Employer of a breach of any of the provisions of this Agreement by the Employee shall
not be construed as a waiver of any subsequent breach by the Employee.

 

14.         Binding Effect; Assignment. The rights and obligations of the Employer under this Agreement shall inure to the benefit
of and shall be binding upon the successors and assigns of the Employer. This Agreement is a personal employment contract and
the rights, obligations and interests of the Employee hereunder may not be sold, assigned, transferred, pledged or hypothecated.

 

15.         Entire Agreement. This Agreement contains the entire agreement and supersedes all prior agreements and understandings,
oral or written, with respect to the subject matter hereof. This Agreement may be changed only by an agreement in writing signed
by the party against whom any waiver, change, amendment, modification or discharge is sought.

 

16.         Headings. The headings contained in this Agreement are for reference purposes only and shall not affect the meaning or
interpretation of this Agreement.

 

17.         Governing Law. This Agreement shall be construed and enforced in accordance with the laws of the Federal District and State
of Florida. Venue for all legal proceedings arising out of this Agreement shall be located only in the state or federal court
with competent jurisdiction in Sarasota County, Florida. 
  

    	9 | Page

    	 

    

  

18.         Notice. All notices which are required or may be given under this Agreement shall
be in writing and shall be deemed to have been duly given when received if personally delivered; when transmitted if transmitted
by telecopy or similar electronic transmission method; one working day after it is sent, if sent by recognized expedited delivery
service; and five days after it is sent, if mailed, first class mail, certified mail, return receipt requested, with
postage prepaid. In each case notice shall be sent to:

 

If
to the Employee:

Hussein
Abu Hassan, Individually

371
front St. West suite 220

Toronto,
Ontario M5v-3S8

 

If
to the Employer:

Walter
J. Kostiuk, as Employer's CEO,

Director
and Chairman of the Board of

Directors

5901
N. Honore Ave. Ste. 110

Sarasota,
FL 34243

 

[Remainder
of Page Intentionally Left Blank; Signature Page Follows]

 

    	10 | Page

    	 

    

 

IN
WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written.

 

EMPLOYER:

	/s/ Walter J.
    Kostiuk	 

MobileBits
Corporation 

			
	BY:  Walter J. Kostiuk , as Employer’s CEO, Director and Chairman of the Board Of Directors
	 	 	 
	STATE
    OF Florida	)
	 	 	) ss.
	COUNTY
OF Sarasota	)

 

On
this 21st day of April, 2014, before me personally came Walter Kostiuk, to me known, who being
duly sworn, did depose and say, that he is the Chief Executive officer of Mobilebits Corporation, the corporation
described in and which executed the foregoing instrument; and that he signed his name thereto by order of the Board of
Directors of said corporation.

 

		 	 
	 	 	Felicia Monique Rousseau 
	 	 	Notary Public
	 	 	 
	EMPLOYEE:

     

    _____________________

    Hussein Abu Hassan, Individually	 

     

     

     	 

     

     

     

 

 

11 | Page

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