Document:

Amendment No. 1 to Manufacturing Services Agreement

 EXHIBIT 10.8B 
 [ * ] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY
BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND
EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT
OF 1934, AS AMENDED. 
 AMENDMENT NO. 1 
 TO 
 MANUFACTURING SERVICES AGREEMENT

 AMENDMENT NO. 1 (this “Amendment”) dated as of November 10, 2006, to that certain MANUFACTURING SERVICES AGREEMENT
dated as of December 20, 2002 (the “Agreement”), by and between Cambrex Bio Science Baltimore, Inc., a Delaware Corporation (“CBSB”), and Tercica Medica, Inc., a Delaware corporation (“Tercica”) (each of CBSB and
Tercica, a “Party” and, collectively, the “Parties”). Defined terms not otherwise defined herein shall have the meanings ascribed to them in the Agreement. 
 WHEREAS, pursuant to the Agreement, subject to certain limitations, CBSB agreed to manufacture, and Tercica agreed to purchase from CBSB, clinical and
commercial quantities of Product; and 
 WHEREAS, the Parties desire to amend the Agreement pursuant to Section 25.9 thereof.

 NOW, THEREFORE, in consideration of the foregoing and the mutual promises and covenants hereinafter set forth, CBSB and Tercica hereby
agree as follows: 
 1. Project Rates. 
 (a) The Parties hereby waive the application of the restriction set forth in the last sentence of Section 3.6.1 to the changes contemplated by this Amendment. Such sentence is hereby deleted from the Agreement.

 (b) The Parties hereby acknowledge and agree that any and all references to “time and materials” in the Agreement,
including, without limitation, in Sections 1.27, 1.53, and 8.5, are hereby deleted. 
 (c) The Parties hereby acknowledge and agree that any
and all references to “on a time and materials basis as set forth in Section 8.3”or “on a time and materials basis as set forth in Section 8.2” in the Agreement, including, without limitation, in Sections
5.1, 5.2, 5.3 and 8.5, are deleted and replaced in their entirety, such that the relevant services are provided “in accordance with the pricing structure set forth in Section 8.3 hereof”. 
 2. Section 4.4.1. Procurement. The last two sentences are hereby amended by deleting such sentences and replacing them in their entirety with
the following: 
 “For so long as pricing is based on a model other than a price per gram model, all Raw Materials, Resins and
Consumables shall be invoiced to Tercica by CBSB at the relevant Acquisition Cost.” 

 3. Amendment to Section 8.3. Section 8.3 of the Agreement is hereby amended by deleting
such section and replacing it in its entirety with the following: 
 “Except as otherwise expressly set forth in this Agreement,
including, without limitation, in Section 8.4, Tercica shall pay CBSB for each Batch (including the Engineering Batches, Clinical Batches and Conformance Batches) of Drug Substance that complies with the terms of this Agreement, the
Master Production Record and the warranties provided in Sections 17.1 and 17.2 hereof, on a per Batch basis. The manufacturing costs per Batch for Calendar Year 2006 (as defined by Change Order CO#155-001-0406-001) is set forth in
Exhibit C attached hereto. The Parties will use commercially reasonable efforts to negotiate and establish a price per Batch for the cGMP manufacturing services used to produce Drug Substance for Calendar Year 2007, and, subject to any
adjustments made pursuant to Section 8.4, for each year thereafter. Such price per Batch shall be calculated based on the Project Rates set forth in Exhibit C and an occupancy model based upon experience of cycle times and occupancy from
those Batches manufactured for Calendar Year 2006 or for the previous Calendar Year, as applicable. The amount and/or pricing structure of the Project Rates may be adjusted in accordance with Section 8.4 below.” 
 4. Amendment to Section 8.4. Section 8.4 of the Agreement is hereby amended by deleting such section and replacing it in its entirety
with the following: 
 “8.4 Revised Drug Substance Pricing. 
 8.4.1 Cost Basis. Following review of the Raw Materials, Resins and Consumables required per Batch, CBSB shall provide Tercica with
the cost basis for such, Raw Materials, Resins and Consumables (the “Consumables Price”), which Tercica shall approve in its reasonable discretion. 
 8.4.2 Price Per Gram Model. The Parties will use commercially reasonable efforts to negotiate and establish a price per gram
pricing model for the cGMP manufacturing services used to produce Drug Substance in lieu of the price per Batch model described in Section 8.3. Such pricing shall be calculated based on the Consumables Price and the price per Batch model
described in Section 8.3 (together, the “Cost Basis”). In no event will the price per gram for any given Calendar Year following the first Calendar Year of the price per Batch model exceed one hundred six percent
(106%) of the price per gram in the previous Calendar Year. 
 8.4.3 Purchase Price. If the Parties do establish a
price per gram, such price shall be the new Project Rate with which to calculate the Purchase Price for the remainder of the Term, unless otherwise agreed upon in writing by the Parties. If the Parties are not able to establish a price per gram, the
Purchase Price shall continue to be calculated as set forth in Section 8.3, unless otherwise agreed upon in writing by the Parties.” 
 [ *
] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS,
HAS BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE
COMMISSION PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934,
AS AMENDED 
  

 2 

 5. Amendment to Section 22.1. The first sentence of Section 22.1 of the Agreement is
hereby amended by deleting such sentence and replacing it in its entirety with the following: 
 “Unless sooner terminated pursuant to
the terms of this Agreement, the term of this Agreement (the “Term”) shall commence on the Effective Date and shall continue until December 31, 2012.” 
 6. Amendment to Exhibit C. The Parties hereby acknowledge and agree that Exhibit C to the Agreement is hereby amended by deleting such
Exhibit and replacing it with the Exhibit C attached to this Amendment. 
 7. Except as expressly set forth herein, all other terms
and conditions of the Agreement shall remain in full force and effect, unamended. This Amendment constitutes the entire agreement of the Parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, oral
and written, among the Parties with respect to the subject matter hereof. 
 8. This Amendment will be governed by and construed in
accordance with the internal substantive laws of the State of New York, without reference to the choice of law doctrine of such state. 
 9.
This Amendment may be executed in counterparts, each of which will be deemed an original, but all of which together will constitute one and the same instrument. 
 10. This Amendment may not be amended or modified, and no provisions hereof may be waived, without the written consent of the Parties. 
 11. Each provision of this Amendment will be treated as a separate and independent clause, and the unenforceability of any one clause will in no way impair the enforceability of any of the other clauses herein. If one
or more of the provisions contained in this Amendment will for any reason be held to be excessively broad as to scope, activity, subject or otherwise, so as to be unenforceable at law, such provision or provisions will be construed by the
appropriate judicial body by limiting or reducing it or them so as to be enforceable to the maximum extent compatible with the applicable law as it will then appear. 
 [ * ] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY
BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND
EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT
OF 1934, AS AMENDED 
  

 3 

 IN WITNESS WHEREOF, the Parties have caused this Amendment to be executed as of the day and year first
above written. 
  

			
	TERCICA MEDICA, INC.
		
	By:	 	 /s/ Andrew Grethlein, Ph.D.

		 	{            }
		 	{            }
	
	CAMBREX BIO SCIENCE BALTIMORE, INC.
		
	By:	 	 /s/ Steve Klosk

		 	{            }
		 	{            }

 [ * ] = CERTAIN CONFIDENTIAL INFORMATION
CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND
FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE
24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED 
  

 4 

 Exhibit C 
 Project Rates 
 Labor Hour rates for mutually agreed Change Orders & Per Batch Pricing Model for
appropriate Calendar Year are charged as follows: 
 Technology Transfer & Project Management activities: 
 $200/hr for services performed through the end of Calendar Year 2005 
 $212/hr for services performed during Calendar Year 2006 
 $225/hr for services performed during Calendar Year 2007 
 $238/hr for services performed during Calendar Year 2008 
 $252/hr for services performed during Calendar Year 2009 
 $267/hr for services performed during Calendar Year 2010 
 $283/hr for services performed during Calendar Year 2011 
 $300/hr for services performed during Calendar Year 2012 
 Process Development activities: 
 $250/hr for services performed through the end of Calendar
Year 2005 
 $265/hr for services performed during Calendar Year 2006 
 $281/hr for services performed during Calendar Year 2007 
 $298/hr for services performed during Calendar Year 2008 
 $316/hr for services performed during Calendar Year 2009 
 $335/hr for services performed during Calendar Year 2010 
 $376/hr for services performed during Calendar Year 2011 
 $399/hr for services performed during Calendar Year 2012 
 Suite Rate: 
 $1,250,000/month for services performed through the end of Calendar Year 2005

 $1,325,000/month for services performed during Calendar Year 2006 
 $1,404,500/month for services performed during Calendar Year 2007 
 $1,488,770/month for services performed during Calendar Year 2008 
 $1,578,010/month for services performed during Calendar Year 2009 
 $1,672,780/month for services performed during Calendar Year 2010 
 $1,773,150/month for services performed during Calendar Year 2011 
 $1,879,500/month for services performed during Calendar Year 2012 
 A 10% discount is applied to the above Suite Rates when applied to the Price Per Batch model. 
 [ * ] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS
DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH
THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE
SECURITIES EXCHANGE ACT OF 1934, AS AMENDED 
  

 5 

 Other Additional Services: 
 $150/hr for services performed through the end of Calendar Year 2005 
 $159/hr for services
performed during Calendar Year 2006 
 $169/hr for services performed during Calendar Year 2007 
 $179/hr for services performed during Calendar Year 2008 
 $190/hr for services performed during Calendar Year 2009 
 $201/hr for services performed during Calendar Year 2010 
 $213/hr for services performed during Calendar Year 2011 
 $226/hr for services performed during Calendar Year 2012 
 The per batch price for Calendar Year 2006 ((as defined by Change Order CO#155-001-0406-001) is [ * ] per batch. 
 These rates do not include: 
  

	 	•	 	 Cost for Raw Materials, Resins and Consumables, Drug Substance testing, or outsourced testing 

 Storage Rates: CBSB’s cost plus 10% (ten percent) 
 [ * ] =
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS
BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION
PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS
AMENDED 
  

 6Exhibit 10.1

    
      

    

    Back
      to Form 8-K

    Exhibit
      10.1

     

    

      APPENDIX
        X

      [Amendment
        #4]

      

      
        	
                Agency
                  Code 12000

              	
                Contract
                  No. C020454

              
	
                Period
                  10/1/06-9/30/08

              	
                Funding
                  Amount for Period Based
                  on approved capitation rates

              

      

      

      This
        is
        an AGREEMENT between THE STATE OF NEW YORK, acting by and through The
        New York State Department of Health,
        having
        its principal office at Corning
        Tower, Room 2001, Empire State Plaza, Albany NY 12237,
        (hereinafter referred to as the STATE), and WellCare
        of New York. Inc.,
        (hereinafter referred to as the CONTRACTOR), to modify Contract Number
C020454
        by
        substituting the attached Appendix L "Approved Capitation Payment Rates."
        The
        effective date of these modifications is October 1, 2006.

       

      All
        other
        provisions of said AGREEMENT shall remain in full force and effect.

       

      IN
        WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the
        dates
        appearing under their signatures.

       

      

      
        	
                CONTRACTOR
                  SIGNATURE

              	
                STATE
                  AGENCY SIGNATURE

              
	
                By:  
                  /s/
                  Todd S. Farha     

              	
                By: /s/
                  Donna Frescatore   

              
	
                Todd
                  S. Farha

              	
                Donna
                  Frescatore   

              
	
                Title:
                  President & CEO

              	
                Title: Deputy
                  Director

              
	
                Date:
                  3/23/2007

              	
                Date:
                  4/6/2007

              
	
                 

              	
                State
                  Agency Certification:

                In
                  addition to the acceptance of this contract, I also certify that
                  original
                  copies of this signature page will be attached to all other exact
                  copies
                  of this contract.

              

      

       

      STATE
        OF
        FLORIDA

      SS.:

      COUNTY
        OF
        HILLSBOROUGH

      

      On
        the 23
        day of March 2007, before me personally appeared Todd S. Farha, to me known,
        who
        being by me duly sworn, did depose and say that he/she resides at Tampa,
        Florida, that he/she is the President and CEO of WellCare of New York, Inc.,
        the
        corporation described herein which executed the foregoing instrument; and
        that
        he/she signed his/her name thereto by order of the board of directors of
        said
        corporation.

       

      (Notary)

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      APPENDIX
        L 

      Approved
        Capitation Payment Rates

       

      APPENDIX
        L

      October
        1, 2006 

      L-l

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

       

      
        	
                MMIS
                  ID#: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Northeast

              
	
                Reinsurance:
                  No

              	
                County:
                  ALBANY

              

      

       

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $266.66

              
	
                TANF/SN
                  6mo-14 F

              	
                $90.84

              
	
                TANF/SN
                  15-20 F

              	
                $132.88
                  

              
	
                TANF/SN
                  6mo-20 M

              	
                $88.65
                  

              
	
                TANF
                  21+ M/F

              	
                $215.57
                  

              
	
                SN
                  21-29 M/F

              	
                $204.54
                  

              
	
                SN
                  30+ M/F

              	
                $370.80
                  

              
	
                SSI
                  6mo-20 M/F

              	
                $179.30
                  

              
	
                SSI
                  21-64 M/F

              	
                $500.80
                  

              
	
                SSI
                  65+ M/F

              	
                $445.49
                  

              
	
                Maternity
                  Kick Payment

              	
                $5,097.14
                  

              
	
                Newborn
                  Kick Payment

              	
                $1,734.99

              

      

      

      Optional
        Benefits Offered:

      
        	
                R
                  Emergency Transportation

              	
                £Dental

              
	
                R
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      WELLCARE
        OF NEW YORK, INC. 

      Medicaid
        Managed Care Rates

      
        	
                MMIS
                  ID#01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Central

              
	
                Reinsurance:
                  No

              	
                County:
                  COLUMBIA

              

      

       

      
        
          	
                  Premium
                    Group

                	
                  Rate
                    Amount

                
	
                  TANF/SN
                    <6mo M/F

                	
                  $257.40

                
	
                  TANF/SN
                    6mo-14 F

                	
                  $83.44

                
	
                  TANF/SN
                    15-20 F

                	
                  $141.87

                
	
                  TANF/SN
                    6mo-20 M

                	
                  $83.83

                
	
                  TANF
                    21+ M/F

                	
                  $232.72

                
	
                  SN
                    21-29 M/F

                	
                  $218.50

                
	
                  SN
                    30+ M/F

                	
                  $374.26

                
	
                  SSI
                    6mo-20 M/F

                	
                  $181.92

                
	
                  SSI
                    21-64 M/F

                	
                  $481.49

                
	
                  SSI
                    65+ M/F

                	
                  $398.31

                
	
                  Maternity
                    Kick Payment

                	
                  $5,466.64

                
	
                  Newborn
                    Kick Payment

                	
                  $1,980.01

                

        

      

      

      
        Optional
          Benefits Offered:

      

      
        	
                R
                  Emergency Transportation

              	
                £Dental

              
	
                R
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

      

      
        	
                MMIS
                  ID #: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region.:
                  Mid-Hudson

              
	
                Reinsurance:
                  No

              	
                County:
                  DUTCHESS

              

      

       

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $270.87

              
	
                TANF/SN
                  6mo-14 F

              	
                $94.94

              
	
                TANF/SN
                  15-20 F

              	
                $137.72

              
	
                TANF/SN
                  6mo-20 M

              	
                $104.62

              
	
                TANF
                  21+ M/F

              	
                $233.20

              
	
                SN
                  21-29 M/F

              	
                $214.30

              
	
                SN
                  30+ M/F

              	
                $435.52

              
	
                SSI
                  6mo-20 M/F

              	
                $179.73

              
	
                SSI
                  21-64 M/F

              	
                $495.51

              
	
                SSI
                  65+ M/F

              	
                $431.82

              
	
                Maternity
                  Kick Payment

              	
                $5,651.55

              
	
                Newborn
                  Kick Payment

              	
                $2,276.59

              

      

       

      
        	
                Optional
                  Benefits Offered:

              	
                 

              
	
                R
                  Emergency Transportation

              	
                £Dental

              
	
                £
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

      

      
        	
                MMIS
                  ID#: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Central

              
	
                Reinsurance:
                  No

              	
                County:
                  GREENE

              

      

      

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $255.17

              
	
                TANF/SN
                  6mo-14 F

              	
                $81.61

              
	
                TANF/SN
                  15-20 F

              	
                $139.56

              
	
                TANF/SN
                  6mo-20 M

              	
                $81.96

              
	
                TANF
                  21+ M/F

              	
                $229.85

              
	
                SN
                  21-29 M/F

              	
                $215.70

              
	
                SN
                  30+ M/F

              	
                $371.16

              
	
                SSI
                  6mo-20 M/F

              	
                $178.82

              
	
                SSI
                  21-64 M/F

              	
                $477.44

              
	
                SSI
                  65+ M/F

              	
                $396.59

              
	
                Maternity
                  Kick Payment

              	
                $5,466.64

              
	
                Newborn
                  Kick Payment

              	
                $1,980.01

              

      

       

      
        	
                Optional
                  Benefits Offered:

              	
                 

              
	
                R
                  Emergency Transportation

              	
                £Dental

              
	
                £
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

      

      
        	
                MMIS
                  ID#: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Mid-Hudson 

              
	
                Reinsurance:
                  No

              	
                County:
                  ORANGE

              

      

       

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $267.68

              
	
                TANF/SN
                  6mo-14 F

              	
                $94.17

              
	
                TANF/SN
                  15-20 F

              	
                $134.59

              
	
                TANF/SN
                  6mo-20 M

              	
                $103.58

              
	
                TANF
                  21+ M/F

              	
                $229.78

              
	
                SN
                  21-29 M/F

              	
                $209.82

              
	
                SN
                  30+ M/F

              	
                $429.39

              
	
                SSI
                  6mo-20 M/F

              	
                $175.89

              
	
                SSI
                  21-64 M/F

              	
                $487.16

              
	
                SSI
                  65+ M/F

              	
                $426.97

              
	
                Maternity
                  Kick Payment

              	
                $5,651.55

              
	
                Newborn
                  Kick Payment

              	
                $2,276.59

              

      

       

      
        	
                Optional
                  Benefits Offered:

              	
                 

              
	
                £
                  Emergency Transportation

              	
                £Dental

              
	
                £
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

      

      

      
        	
                MMIS
                  ID#: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Northeast

              
	
                Reinsurance:
                  No

              	
                County:
                  RENSSELAER

              

      

       

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $264.44

              
	
                TANF/SN
                  6mo-14 F

              	
                $89.01

              
	
                TANF/SN
                  15-20 F

              	
                $130.59

              
	
                TANF/SN
                  6mo-20 M

              	
                $86.79

              
	
                TANF
                  21+ M/F

              	
                $212.69

              
	
                SN
                  21-29 M/F

              	
                $201.74

              
	
                SN
                  30+ M/F

              	
                $367.69

              
	
                SSI
                  6mo-20 M/F

              	
                $176.21

              
	
                SSI
                  21-64 M/F

              	
                $496.76

              
	
                SSI
                  65+ M/F

              	
                $443.78

              
	
                Maternity
                  Kick Payment

              	
                $5,097.14

              
	
                Newborn
                  Kick Payment

              	
                $1,734.99

              

      

       

      
        	
                Optional
                  Benefits Offered:

              	
                 

              
	
                R
                  Emergency Transportation

              	
                £Dental

              
	
                £
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

      

      
        	
                MMIS
                  ID#: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Northern Metro

              
	
                Reinsurance:
                  No

              	
                County:
                  ROCKLAND

              

      

      

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $250.95

              
	
                TANF/SN
                  6mo-14 F

              	
                $88.86

              
	
                TANF/SN
                  15-20 F

              	
                $113.17

              
	
                TANF/SN
                  6mo-20 M

              	
                $99.37

              
	
                TANF
                  21+ M/F

              	
                $193.00

              
	
                SN
                  21-29 M/F

              	
                $266.43

              
	
                SN
                  30+ M/F

              	
                $419.43

              
	
                SSI
                  6mo-20 M/F

              	
                $178.93

              
	
                SSI
                  21-64 M/F

              	
                $556.61

              
	
                SSI
                  65+ M/F

              	
                $419.43

              
	
                Maternity
                  Kick Payment

              	
                $4,812.65

              
	
                Newborn
                  Kick Payment

              	
                $1,569.65

              

      

       

      
        	
                Optional
                  Benefits Offered:

              	
                 

              
	
                R
                  Emergency Transportation

              	
                £Dental

              
	
                £
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      WELLCARE
        OF NEW YORK, INC.

      Medicaid
        Managed Care Rates

       

      
        	
                MMIS
                  ID#: 01182503

              	
                Effective
                  Date: 10/01/06

              
	
                Approved
                  by DOB: Yes

              	
                Region:
                  Mid-Hudson 

              
	
                Reinsurance:
                  No

              	
                County:
                  ULSTER

              

      

       

      
        	
                Premium
                  Group

              	
                Rate
                  Amount

              
	
                TANF/SN
                  <6mo M/F

              	
                $267.68

              
	
                TANF/SN
                  6mo-14 F

              	
                $94.17

              
	
                TANF/SN
                  15-20 F

              	
                $134.59

              
	
                TANF/SN
                  6mo-20 M

              	
                $103.58

              
	
                TANF
                  21+ M/F

              	
                $229.78

              
	
                SN
                  21-29 M/F

              	
                $209.82

              
	
                SN
                  30+ M/F

              	
                $429.39

              
	
                SSI
                  6mo-20 M/F

              	
                $175.89

              
	
                SSI
                  21-64 M/F

              	
                $487.16

              
	
                SSI
                  65+ M/F

              	
                $426.97

              
	
                Maternity
                  Kick Payment

              	
                $5,651.55

              
	
                Newborn
                  Kick Payment

              	
                $2,276.59

              

      

       

      
        	
                Optional
                  Benefits Offered:

              	
                 

              
	
                £
                  Emergency Transportation

              	
                £Dental

              
	
                £
                  Non-Emergent Transportation

              	
                R
                  Family Planning

              
	
                 

                Box
                  will be checked if the optional benefit is covered by the
                  plan

              

      

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      WELLCARE
        OF NEW YORK, INC.

      

      Family
        Health Plus Rates Effective April 1, 2006

      

      
        	 	
                Optional
                  benefits covered

              
	
                County

              	
                Adults
                  with Children 19 - 64

              	
                Adults
                  without Children 19 - 29

              	
                Adults
                  without Children 30 - 64

              	
                Maternity
                  Kick

              	
                Family
                  Planning

              	
                Dental

              
	
                ALBANY
                  

              	
                $253.35

              	
                $250.47

              	
                $510.54

              	
                $5,097.14

              	
                Yes

              	
                Yes

              
	
                COLUMBIA
                  

              	
                $270.53

              	
                $258.71

              	
                $498.03

              	
                $5,466.64

              	
                Yes

              	
                Yes

              
	
                DUTCHESS
                  

              	
                $260.42

              	
                $291.38

              	
                $528.18

              	
                $5,651.55

              	
                Yes

              	
                Yes

              
	
                GREENE
                  

              	
                $270.53

              	
                $258.71

              	
                $498.03

              	
                $5,466.64

              	
                Yes

              	
                Yes

              
	
                ORANGE
                  

              	
                $260.42

              	
                $291.38

              	
                $528.18

              	
                $5,651.55

              	
                Yes

              	
                Yes

              
	
                RENSSELAER
                  

              	
                $253.35

              	
                $250.47
                  .

              	
                $510.54

              	
                $5,097.14

              	
                Yes

              	
                Yes

              
	
                ROCKLAND
                  

              	
                $256.16

              	
                $208.81

              	
                $471.77

              	
                $4,812.65

              	
                Yes

              	
                Yes

              
	
                ULSTER
                  

              	
                $260.42

              	
                $291.38

              	
                $528.18

              	
                $5,651.55

              	
                Yes

              	
                Yes

              
	
                NEW
                  YORK CITY 

              	
                $196.82

              	
                $151.39

              	
                $245.60

              	
                $5,114.41

              	
                Yes

              	
                Yes

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00123-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00123-of-00352.parquet"}]]