Document:

h1112benefitattestation.htm

Back to Form 8-K

Exhibit 10.7

Medicare Advantage Attestation of Benefit Plan 

 

WELLCARE OF GEORGIA, INC.

 

H1112 

 

Date: 08/29/2012

 

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 above­stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. 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 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 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

	
006

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
17.90

	
08/20/2012

	
01/01/2013

	
027

	
0

	
7

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

 

 

 

	
H1112

  

  

  

 

	 THOMAS TRAN	 	 8/29/2012 11:03:44 AM	 
	  	 	 	 
	 Contracting Official Name	 	 Date	 
	 	 	 	 
	 	 	 	 
	 	 	 8735 Henderson Rd	 
	 	 	 Ren 1	 
	 WELLCARE OF GEORGIA, INC.	 	 Tampa, FL 33634	 
	 	 	 	 
	 Organization	 	 Address	 

 

 

 

 

 

 

H1112h1216benefitattestation.htm

Back to 8-K

Exhibit 10.8

Medicare Advantage Attestation of Benefit Plan 

 

HARMONY HEALTH PLAN OF ILLINOIS, INC.

 

H1216 

 

Date: 08/29/2012

 

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 above­stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. 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 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

 

	
Plan

ID

	
Segment

ID

	
Version

	
Plan Name

	
Plan

Type

	
Transaction

Type

	
MA

Premium

	
Part D 

Premium

	
CMS Approval 

Date

	
Effective

Date

	
001

	
0

	
7

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

	
003

	
0

	
7

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
23.30

	
08/20/2012

	
01/01/2013

 

	
H1216

  

  

  

 

 

 

	 THOMAS TRAN	 	 8/29/2012 2:02:26 PM	 
	  	 	 	 
	 Contracting Official Name	 	 Date	 
	 	 	 	 
	 	 	 	 
	 	 	 23 Public Square	 
	 	 	 Suite 400	 
	 HARMONY HEALTH PLAN OF ILLINOIS, INC.	 	 Belleville, IL 62220	 
	 	 	 	 
	 Organization	 	 Address	 

 

 

 

 

H1216h1264benefitattestation.htm

Back to 8-K

Exhibit 10.9

 

Medicare Advantage Attestation of Benefit Plan 

 

WELLCARE OF TEXAS, INC.

 

H1264 

 

Date: 08/29/2012

 

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 above­stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. 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 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

 

	
Plan

ID

	
Segment

ID

	
Version

	
Plan Name

	
Plan

Type

	
Transaction

Type

	
MA

Premium

	
Part D 

Premium

	
CMS Approval 

Date

	
Effective

Date

	
004

	
0

	
7

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

	
007

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
18.00

	
08/20/2012

	
01/01/2013

	
008

	
0

	
7

	
WellCare Dividend (HMO)

	
HMO

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

	
018

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
12.70

	
08/20/2012

	
01/01/2013

 

	
H1264

  

  

  

 

	 THOMAS TRAN	 	 8/29/2012 2:03:17 PM	 
	  	 	 	 
	 Contracting Official Name	 	 Date	 
	 	 	 	 
	 	 	 	 
	 	 	 8735 Henderson Rd	 
	 	 	 Ren 1	 
	 WELLCARE OF TEXAS, INC.	 	 Tampa, FL 33634	 
	 	 	 	 
	 Organization	 	 Address	 

 

 

 

H1264h1416benefitattestation.htm

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Exhibit 10.10

 

Medicare Advantage Attestation of Benefit Plan 

 

HARMONY HEALTH PLAN OF ILLINOIS, INC. 

 

H1416 

 

Date: 08/29/2012

 

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 above­stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. 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 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).

 

	
Plan

ID

	
Segment

ID

	
Version

	
Plan Name

	
Plan

Type

	
Transaction

Type

	
MA

Premium

	
Part D 

Premium

	
CMS Approval 

Date

	
Effective

Date

	
007

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
7.50

	
08/20/2012

	
01/01/2013

	
009

	
0

	
7

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

	
019

	
0

	
7

	
WellCare Rx (HMO)

	
HMO

	
Renewal

	
0.00

	
25.30

	
08/20/2012

	
01/01/2013

 

 

 

	

H1416 

  

  

  

 

	 THOMAS TRAN	 	 8/29/2012 2:04:31 PM	 
	  	 	 	 
	 Contracting Official Name	 	 Date	 
	 	 	 	 
	 	 	 	 
	 	 	 	 
	 	 	 125 SOUTH WACKER DRIVE SUITE 2600	 
	 HARMONY HEALTH PLAN OF ILLINOIS, INC.	 	 CHICAGO, IL 606064402	 
	 	 	 	 
	 Organization	 	 Address	 

 

 

 

 

 

H1416h1903benefitattestation.htm

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Exhibit 10.11

Medicare Advantage Attestation of Benefit Plan 

 

WELLCARE OF LOUISIANA, INC.

 

H1903 

 

Date: 08/29/2012

 

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 above­stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. 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 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 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

	
011

	
0

	
6

	
WellCare Access (HMO SNP)

	
HMO

	
Renewal

	
0.00

	
26.00

	
08/20/2012

	
01/01/2013

	
022

	
0

	
6

	
WellCare Value (HMO -POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

 

 

 

	

H1903 

  

  

  

 

	 THOMAS TRAN	 	 8/29/2012 2:05:23 PM	 
	  	 	 	 
	 Contracting Official Name	 	 Date	 
	 	 	 	 
	 	 	 	 
	 	 	 8735 Henderson Rd	 
	 	 	 Ren 1	 
	 WELLCARE OF LOUISIANA, INC.	 	 Tampa, FL 33634	 
	 	 	 	 
	 Organization	 	 Address	 

 

 

 

 

H1903h2491benefitattestation.htm

Back to Form 8-K

Exhibit 10.12

Medicare Advantage Attestation of Benefit Plan 

 

WELLCARE HEALTH INSURANCE OF ARIZONA, INC.

 

H2491 

 

Date: 08/29/2012

 

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 above­stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. 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 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 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

	
7

	
'Ohana Value (HMO- POS)

	
HMOPOS

	
Renewal

	
0.00

	
0.00

	
08/20/2012

	
01/01/2013

	
004

	
0

	
6

	
'Ohana Liberty (HMO- POS SNP)

	
HMOPOS

	
Renewal

	
0.00

	
33.30

	
08/20/2012

	
01/01/2013

 

	
H2491

  

  

  

 

	 THOMAS TRAN	 	 8/29/2012 2:06:20 PM	 
	  	 	 	 
	 Contracting Official Name	 	 Date	 
	 	 	 	 
	 	 	 	 
	 	 	 8735 Henderson Rd	 
	 	 	 Ren 1	 
	 WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	 	 Tampa, FL 33634	 
	 	 	 	 
	 Organization	 	 Address	 

 

 

 

H2491

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