Document:

EX-10.1

Exhibit 10.1

WELL CARE HMO, INC., D/B/A STAYWELL Medicaid HMO Contract

HEALTH PLAN OF FLORIDA

AHCA CONTRACT NO. FA522

AMENDMENT NO. 9

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE
ADMINISTRATION, hereinafter referred to as the “Agency” and WELL CARE HMO, INC., D/B/A STAYWELL
HEALTH PLAN OF FLORIDA, hereinafter referred to as the “Vendor”, is hereby amended as follows:

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

To pay for contracted services according to the conditions of Attachment I in an amount not to
exceed $663,757,222.00 (an increase of $6,488,350.00), subject to the availability of funds.

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

Table 2

Age-banded Capitation Rates for all Agency Areas of the State.

July 1, 2005 through August 31, 2005 — Estimated HMO rates; not for use unless approved by CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 07 General Rates Plan -
	 	 	 	 	 	015016913 (BREVARD)	 	 	 	 	 	 	 	 	 	 	 	 
	BTHMO+2MO
	 	 	 	 	 	3MO-11MO1-56-1314-20 (P)14 -20 (M)21-54 (F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		894.04		 		178.5687.80     56.33  122.97    63.04238.18154.51		 		322.34     322.34		 	 	 	 	 	 	 	 
	SSI/No Medicare
	 		8976.51		 		1573.97      404.51    212.74  232.25    232.25701.12701.12    661.11     661.11		 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part B
	 		308.90		 		308.90     308.90     308.90  308.90        308.90308.90308.90    308.90     308.90		 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part A & B
	 		284.51		 		284.51284.51    284.51  284.51        284.51284.51284.51		 		284.51     198.54		 	 	 	 	 	 	 	 
	Area 09 General Rates Plan -
	 	 	 	 	 	015016910(PALM BEACH)	 	 	 	 	 	 	 	 	 	 	 	 
	BTHMO+2MO
	 	 	 	 	 	3MO-11MO1-56-1314-20(F)14-20(M)21-54(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		850.65		 		169.5683.3253.28116.6359.62225.69		 		146.30		 		304.86		 		304.86	
	SSI/No Medicare
	 		9123.67		 		1599.06410.92216.11235.92235.92711.70		 		711.70		 		670.95		 		670.95	
	SSI/Part B
	 		288.69		 		288.69288.69288.69288.69288.69288.69		 		288.69		 		288.69		 		288.69	
	SSI/Part A & B
	 		317.25		 		317.25317.25317.25317.25317.25317.25		 		317.25		 		317.25		 		221.58	
	Area 10 General Rates Plan -
	 	 	 	 	 	015016900(BROWARD)	 	 	 	 	 	 	 	 	 	 	 	 
	BTHMO+2MO
	 	 	 	 	 	3MO-11MO1-56-1314-20(F)14-20(M)21-54(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		854.17		 		170.8684.1154.07117.8260.56228.83		 		148.48		 		309.80		 		309.80	
	SSI/No Medicare11134.67
	 	 	 	 	 		1955.18502.14264.85289.15289.15873.08		 		873.08		 		823.33		 		823.33	
	SSI/Part B
	 		316.19		 		316.19316.19316.19316.19316.19316.19		 		316.19		 		316.19		 		316.19	
	SSI/Part A & B
	 		341.03		 		341.03341.03341.03341.03341.03341.03		 		341.03		 		341.03		 		238.56	
	Area 11 General Rates plus Transportation

	 	Plan - 015016909(DADE)	 	 	 	 	 	 	 	 	 	 	 	 
	BTHMO+2MO
	 	 	 	 	 	3MO-11MO       1-5        6-13   14-20(F)   14-20(M)  21-54(P)    21-54(M)       55-64      65+	 	 	 	 	 	 	 	 	 	 	 	 
	TANF/FC/SOBRA 1112.08
	 	 	 	 	 		221.47    108.96       69.38    152.49       77.84    294.30      190.48      396.50     396.50		 	 	 	 	 	 	 	 	 	 	 	 
	SSI/No Medicare 12145.44	 	2131.38 551.08 286.49 314.89 314.89 952.30 952.30 894.10 894.10
	 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part B 455.34	 	455.34 455.34 455.34 455.34 455.34 455.34 455.34 455.34 455.34
	 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part A & B
	 		433.96		 		433.96    433.96      433.96    433.96      433.96    433.96      433.96     433.96      299.72		 	 	 	 	 	 	 	 	 	 	 	 

September 1, 2005 through December 31, 2005 — Estimated HMO rates; not for use unless

approved by CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 09 General Rates Plan -

	 	015016910(PALM BEACH)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(P)	 		14-20(M}		 		21-54	(P)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		850.65		 		169.56		 		83.32		 		53.28		 		116.63		 		59.62		 		225.69		 		146.30		 		304.86		 		304.86	
	SSI/No Medicare
	 		9123.67		 		1599.06		 		410.92		 		216.11		 		235.92		 		235.92		 		711.70		 		711.70		 		670.95		 		670.95	
	SSI/Part B
	 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69	
	SSI/Part A & B
	 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		221.58	
	Area 10 General Rates Plan -

	 	015016900(BROWARD)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		854.17		 		170.86		 		84.11		 		54.07		 		117.82		 		60.56		 		228.53		 		148.48		 		309.80		 		309.80	
	SSI/No Medicare
	 		11134.67		 		1955.18		 		502.14		 		264.85		 		289.15		 		289.15		 		873.08		 		873.08		 		823.33		 		823.33	
	SSI/Part B
	 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19	
	SSI/Part A & B
	 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		238.55	

AHCA Contract No. FA522, Amendment No. 9, Page 1 of 4

AHCA Form 2100-0002 (Rev. NOV03)

WELL CARE HMO, INC., D/B/A STAYWELL Medicaid HMO Contract

HEALTH PLAN OF FLORIDA

January 1, 2006 through June 30, 2006 — Estimated HMO rates; not for use unless approved by CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 09 General Rates Plan -

	 	015016910(PALM BEACH)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		850.65		 		169.56		 		83.32		 		53.28		 		116.63		 		59.62		 		225.69		 		146.30		 		304.86		 		304.86	
	SSI/No Medicare
	 		9123.67		 		1599.06		 		410.92		 		216.11		 		235.92		 		235.92		 		711.70		 		711.70		 		670.95		 		670.95	
	SSI/Part B
	 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44	
	SSI/Part A & B
	 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		66.48	
	Area 10 General Rates Plan -

	 	015016900(BROWARD)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54{M	)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		854.17		 		170.86		 		84.11		 		54.07		 		117.82		 		60.56		 		228.53		 		148.48		 		309.80		 		309.80	
	SSI/No Medicare
	 		11134.67		 		1955.18		 		502.14		 		264.85		 		289.15		 		289.15		 		873.08		 		873.08		 		823.33		 		823.33	
	SSI/Part B
	 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90	
	SSI/Part A & B
	 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		71.59	

        .

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

Table 3

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

Management

July 1, 2005 through August 31, 2005 — Estimated HMO rates; not for use unless approved by CMS.

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

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO	 	3MO-11MO	 	 	1-5 6-13 14-20	(F)	 	14-20(M) 21-54(F) 21-54(M)
	 	 	 	 	 	 	55-64 65+	 	 	 	 	 	 	 	 	 	 	 	 	 
	TANF/FC/SOBRA	 	 	956.51	 	 	 	190.37	 	 	 	94.52 67.12 136.49	 	 	72.38 254.10 164.92342.33
	 	 	 	 	 	 	342.33	 	 	 	 	 	 	 	 	 	 	 	 	 
	SSI/No Medicare	 	 	8796.56	 	 	 	1536.63	 	 	 	401.17 243.67 248.87	 	 	248.87 702.91 702.91
	 	 	 	 	 	 	649.30	 	 	 	649.30	 	 	 	 	 	 	 	 	 
	SSI/Part B	 	 	356.54	 	 	 	356.54	 	 	 	356.54 356.54 356.54	 	 	356.54 356.54 356.54
	 	 	 	 	 	 	356.54	 	 	 	356.54	 	 	 	 	 	 	 	 	 
	SSI/Part A & B	 	 	299.65	 	 	 	299.65	 	 	 	299.65 299.65 29	 	 	9.65 299.65 299.65 299.65
	 	 	 	 	 	 	299.65	 	 	 	211.35	 	 	 	 	 	 	 	 	 
	Area 05 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016903(PASCO) 015016904(PINELLAS)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(P)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	919.98	 	 	 	183.43	 	 	 	91.15	 	 	 	64.87	 	 	 	131.62	 	 	 	69.93	 	 	 	245.33	 	 	 	159.49	 	 	 	331.03	 	 	 	331.03	 
	SSI/No Medicare
	 	 	9248.02	 	 	 	1615.41	 	 	 	420.86	 	 	 	252.27	 	 	 	258.55	 	 	 	258.55	 	 	 	735.80	 	 	 	738.80	 	 	 	681.19	 	 	 	681.19	 
	SSI/Part B
	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 
	SSI/Part A & B
	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	227.10	 
	Area 06 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016902(HILLSBOROUGH) 015016905(POLK) 015016912(MANATEE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	839.91	 	 	 	168.14	 	 	 	84.80	 	 	 	67.94	 	 	 	131.59	 	 	 	75.16	 	 	 	230.12	 	 	 	151.25	 	 	 	309.66	 	 	 	309.66	 
	SSI/No Medicare
	 	 	8536.50	 	 	 	1494.29	 	 	 	393.28	 	 	 	262.75	 	 	 	284.04	 	 	 	284.04	 	 	 	746.59	 	 	 	746.59	 	 	 	653.76	 	 	 	653.76	 
	SSI/Part B
	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 
	SSI/Part A & B
	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	202.46	 
	Area 07 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016906 (ORANGE) 015016907(OSCEOLA) 015016908 (SEMINOLE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	894.05	 	 	 	178.57	 	 	 	89.54	 	 	 	68.64	 	 	 	132.32	 	 	 	72.39	 	 	 	240.41	 	 	 	156.74	 	 	 	324.62	 	 	 	324.62	 
	SSI/No Medicare
	 	 	8976.52	 	 	 	1573.98	 	 	 	414.04	 	 	 	264.97	 	 	 	264.82	 	 	 	264.82	 	 	 	733.66	 	 	 	733.66	 	 	 	674.72	 	 	 	674.72	 
	SSI/Part B
	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 
	SSI/Part A & B
	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	210.25	 
	Area 08 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015016911(LEE)	 	 	 	 	 	015016914(SARASOTA)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	785.83	 	 	 	156.86	 	 	 	78.13	 	 	 	56.61	 	 	 	113.39	 	 	 	60.74	 	 	 	210.44	 	 	 	136.92	 	 	 	284.23	 	 	 	284.23	 
	SSI/No Medicare
	 	 	8247.94	 	 	 	1440.21	 	 	 	376.25	 	 	 	229.28	 	 	 	234.06	 	 	 	234.06	 	 	 	659.32	 	 	 	659.32	 	 	 	608.59	 	 	 	608.59	 
	SSI/Part B
	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 
	SSI/Part A & B
	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	210.20	 

September 1, 2005 through December 31, 2005 — Estimated HMO rates; not for use unless approved
by CMS.

	 	 	 	 	 	 	 	 	 
	Area 03 General Rates plus Mental Health
	 	Plan - 015016901(HERNANDO)
	 	 	 	 
	BTHMO+2MO
	 	3MO-11MO      1-5        6-13  14-20(F)    14-20(M)  21-54(F)    21-54(M)       55-64	 		65+	

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	TANF/FC/SOBRA 956.51 190.37 94.52 67.12 136.49 72.38 254.10
	 	 	164.92 342.33 342.33	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	SSI/No Medicare 8796.56 1536.63 401.17 243.67 248.87 248.87 702.91
	 	 	702.91 649.30 649.30	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part B 356.54 356.54 356.54 356.54 356.54 356.54 356.54
	 	 	356.54 356.54 356.54	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part A & B 299.65 299.65 299.65 299.65 29
	 	9.65 299.65 299.65 299.65 299.65 211.35
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	AHCA Contract No. FA522, Amendment No. 9, Page 2 of 4
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	AHCA Form 2100-0002 (Rev. NOV03)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	WELL CARE HMO, INC., D/B/A STAYWELL

	 	 		 	 	 		 	 	 		 	 	 		 	 	 		 	 	 		 	 	Medicaid HMO Contract	 	 	 	 	 	 	 	 
	HEALTH PLAN OF FLORIDA
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 05 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016903(PASCO) 015016904(PINELLAS)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	919.98	 	 	 	183.43	 	 	 	91.15	 	 	 	64.87	 	 	 	131.62	 	 	 	69.93	 	 	 	245.33	 	 	 	159.49	 	 	 	331.03	 	 	 	331.03	 
	SSI/No Medicare
	 	 	9248.02	 	 	 	1615.41	 	 	 	420.86	 	 	 	252.27	 	 	 	258.55	 	 	 	258.55	 	 	 	735.80	 	 	 	735.80	 	 	 	681.19	 	 	 	681.19	 
	SSI/Part B
	 	 	332.83	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 
	SSI/Part A & B
	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	227.10	 
	Area 06 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016902(HILLSBOROUGH) 015016905(POLK) 015016912(MANATEE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	839.91	 	 	 	168.14	 	 	 	84.80	 	 	 	67.94	 	 	 	131.59	 	 	 	75.16	 	 	 	230.12	 	 	 	151.25	 	 	 	309.66	 	 	 	309.66	 
	SSI/No Medicare
	 	 	8536.50	 	 	 	1494.29	 	 	 	393.28	 	 	 	262.75	 	 	 	284.04	 	 	 	284.04	 	 	 	746.59	 	 	 	746.59	 	 	 	653.76	 	 	 	653.76	 
	SSI/Part B
	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 
	SSI/Part A & B
	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	202.46	 
	Area 07 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016906(ORANGE) 015016907(OSCEOLA) 015016908(SEMINOLE) 015016913(BREVARD)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	894.05	 	 	 	178.57	 	 	 	89.54	 	 	 	68.64	 	 	 	132.32	 	 	 	72.39	 	 	 	240.41	 	 	 	156.74	 	 	 	324.62	 	 	 	324.62	 
	SSI/No Medicare
	 	 	8976.52	 	 	 	1573.98	 	 	 	414.04	 	 	 	264.97	 	 	 	264.82	 	 	 	264.82	 	 	 	733.66	 	 	 	733.66	 	 	 	674.72	 	 	 	674.72	 
	SSI/Part B
	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 
	SSI/Part A & B
	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	210.25	 
	Area 08 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015016911(LEE)	 	 	 	 	 	015016914(SARASOTA)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	785.53	 	 	 	156.86	 	 	 	78.13	 	 	 	56.61	 	 	 	113.39	 	 	 	60.74	 	 	 	210.44	 	 	 	136.92	 	 	 	284.23	 	 	 	284.23	 
	SSI/No Medicare
	 	 	8247.94	 	 	 	1440.21	 	 	 	376.25	 	 	 	229.28	 	 	 	234.06	 	 	 	234.06	 	 	 	659.32	 	 	 	659.32	 	 	 	608.59	 	 	 	608.59	 
	SSI/Part B
	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 
	SSI/Part A & B
	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	210.20	 

Area 11 General Rates plus Mental Health plus Transportation Plan — 015016909(DADE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	1112.09	 	 	 	221.48	 	 	 	110.76	 	 	 	82.14	 	 	 	162.18	 	 	 	87.53	 	 	 	296.62	 	 	 	192.80	 	 	 	398.87	 	 	 	398.87	 
	SSI/No Medicare
	 	 	12145.45	 	 	 	2131.39	 	 	 	560.13	 	 	 	336.09	 	 	 	345.82	 	 	 	345.82	 	 	 	983.20	 	 	 	983.20	 	 	 	907.03	 	 	 	907.03	 
	SSI/Part B
	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 
	SSI/Part A & B
	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	305.52	 

January 1, 2006 through June 30, 2006 — Estimated HMO rates; not for use unless approved by
CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 03 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016901(HERNANDO)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		956.51		 		190.37		 		94.52		 		67.12		 		136.49		 		72.38		 		254.10		 		164.92		 		342.39		 		342.33	
	SSI/No Medicare
	 		8796.56		 		1536.63		 		401.17		 		243.67		 		248.87		 		248.87		 		702.91		 		702.91		 		649.30		 		649.30	
	SSI/Part B
	 		237.65		 		237.65		 		237.65		 		237.65		 		237.65		 		237.65		 		237.65		 		237.65		 		237.65		 		237.65	
	SSI/Part A & B
	 		83.24		 		83.24		 		83.24		 		83.24		 		83.24		 		83.24		 		83.24		 		83.24		 		83.24		 		73.70	
	Area 05 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016903(PASCO) 015016904(PINELLAS)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		919.98		 		183.43		 		91.15		 		64.87		 		131.62		 		69.93		 		245.33		 		159.49		 		331.03		 		331.03	
	SSI/No Medicare
	 		9248.02		 		1615.41		 		420.86		 		252.27		 		258.55		 		258.55		 		735.80		 		735.80		 		681.19		 		681.19	
	SSI/Part B
	 		214.59		 		214.59		 		214.59		 		214.59		 		214.59		 		214.59		 		214.59		 		214.59		 		214.59		 		214.59	
	SSI/Part A & B
	 		83.91		 		83.91		 		83.91		 		83.91		 		83.91		 		83.91		 		83.91		 		83.91		 		83.91		 		74.53	
	Area 06 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016902(HILLSBOROUGH) 015016905(POLK) 015016912(MANATEE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		839.91		 		168.14		 		84.80		 		67.94		 		131.99		 		75.16		 		230.12		 		151.25		 		309.66		 		109.66	
	SSI/No Medicare
	 		8536.50		 		1494.29		 		393.28		 		262.75		 		284.04		 		284.04		 		746.59		 		746.59		 		653.76		 		653.76	
	SSI/Part B
	 		201.26		 		201.26		 		201.26		 		201.26		 		201.26		 		201.26		 		201.26		 		201.26		 		201.26		 		201.26	
	SSI/Part A & B
	 		73.23		 		73.23		 		73.23		 		73.23		 		73.23		 		73.23		 		73.23		 		73.23		 		73.23		 		64.45	
	Area 07 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015016906(OR/LNGE) 015016907(OSCEOLA) 015016908(SEMINOLE) 015016913(BREVARD)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		894.05		 		178.57		 		89.54		 		68.64		 		132.32		 		72.39		 		240.41		 		156.74		 		324.62		 		324.62	
	SSI/No Medicare
	 		8976.52		 		1573.98		 		414.04		 		264.97		 		264,82		 		264.82		 		733.66		 		733.66		 		674.72		 		674.72	
	SSI/Part B
	 		203.20		 		203.20		 		203.20		 		203.20		 		203.20		 		203.20		 		203.20		 		203.20		 		203.20		 		203.20	
	SSI/Part A & B
	 		84.13		 		84.13		 		84.13		 		84.13		 		84.13		 		84.13		 		84.13		 		84.13		 		84.13		 		74.97	
	Area 08 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015016911(LEE)	 	 	 	 	 	015016914(SARASOTA)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		59-64		 		65	*
	TANF/FC/SOBRA
	 		785.53		 		156.86		 		78.13		 		56.61		 		113.39		 		60.74		 		210.44		 		136.92		 		284.23		 		284.23	
	SSI/No Medicare
	 		8247.94		 		1440.21		 		376.25		 		229.28		 		234.06		 		234.06		 		659.32		 		659.32		 		608.59		 		608.59	
	SSI/Part B
	 		191.91		 		191.91		 		191.91		 		191.91		 		191.91		 		191.91		 		191.91		 		191,91		 		191.91		 		191.91	
	SSI/Part A & B
	 		77.95		 		77.95		 		77.95		 		77.95		 		77.95		 		77.95		 		77.95		 		77.95		 		77.95		 		69.13	

AHCA Contract No. FA522, Amendment No. 9, Page 3 of 4

AHCA Form 2100-0002 (Rev. NOV03)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	WELL CARE HMO, INC., D/B/A STAYWELL	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicaid HMO contract	 	 	 	 	 	 	 	 
	HEALTH PLAN OF FLORIDA	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area11 General Rates plus Mental Health plus Transportation Plan - 015016909(DADE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	1112.09	 	 	 	221.48	 	 	 	110.76	 	 	 	82.14	 	 	 	162.18	 	 	 	87.53	 	 	 	296.62	 	 	 	192.80	 	 	 	398.87	 	 	 	398.87	 
	SSI/No Medicare
	 	 	12145.45	 	 	 	2131.39	 	 	 	560.13	 	 	 	336.09	 	 	 	345.82	 	 	 	345.82	 	 	 	983.20	 	 	 	983.20	 	 	 	907.03	 	 	 	907.03	 
	SSI/Part B
	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 
	SSI/Part A & B
	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	109.55	 

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

Notwithstanding the payment amounts which may be computed with the above rate table, the sum of
total capitation payments under this contract shall not exceed the total contract amount of
$663,757,222.00 (an increase of $6,488,350.00) expressed on page seven of this contract.

	 	5.	 	This amendment shall begin on September 1, 2005, or the date on which the amendment has been
signed by both parties, whichever is later.

All provisions in the Contract and any attachments thereto in conflict with this amendment
shall be and are hereby changed to conform with this amendment.

All provisions not in conflict with this amendment are still in effect and are to be performed
at the level specified in the Contract.

This amendment and all its attachments are hereby made a part of the Contract.

This amendment cannot be executed unless all previous amendments to this Contract have been
fully executed.

IN WITNESS WHEREOF, the parties hereto have caused this 4 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.

	 	 	 
	WELLCARE HMO, INC., D/B/A STAYWELL

HEALTH PLAN OF FLORIDA

	 	STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION
	 
	 	 
	SIGNED

	 	SIGNED

BY:/s/ Todd S. Farha     
BY:     [Illegible]     

	 	 	 
	 	 	NAME: Todd S. Farha	 	 	 	NAME: Alan Levine
	 	 	TITLE: President & CEO	 	 	 	TITLE: Secretary

DATE: 8/31/05 DATE:     9/1/05     

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. FA522, Amendment No. 9, Page 4 of 4

AHCA Form 2100-0002 (Rev. NOV03)EX-10.2

Exhibit 10.2

HEALTHEASE OF FLORIDA, INC. Medicaid HMO Contract

AHCA CONTRACT NO. FA521

AMENDMENT NO. 8

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE
ADMINISTRATION, hereinafter referred to as the “Agency” and HEALTHEASE OF FLORIDA, INC.,
hereinafter referred to as the “Vendor”, is hereby amended as follows:

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

To pay for contracted services according to the conditions of Attachment I in an amount not to
exceed $833,550,430.00, (an increase of $12,618,094.00), subject to the availability of funds.

2. Attachment I, section 90.0, Payment and Authorized Enrollment Levels, Table 1, is hereby

amended to now read:

Table 1 Projected Enrollment

	 	 	 	 	 
	County
	 	Maximum Enrollment Level

	 
	 	 	 	 
	BREVARD
	 	 	14,000	 
	 
	 	 	 	 
	BROWARD
	 	 	13,500	 
	 
	 	 	 	 
	CALHOUN
	 	 	800	 
	 
	 	 	 	 
	CITRUS
	 	 	7,500	 
	 
	 	 	 	 
	DUVAL
	 	 	55,000	 
	 
	 	 	 	 
	ESCAMBIA
	 	 	18,000	 
	 
	 	 	 	 
	GADSDEN
	 	 	3,500	 
	 
	 	 	 	 
	HIGHLANDS
	 	 	3,000	 
	 
	 	 	 	 
	HILLSBOROUGH
	 	 	18,000	 
	 
	 	 	 	 
	JEFFERSON
	 	 	1,000	 
	 
	 	 	 	 
	LAKE
	 	 	7,000	 
	 
	 	 	 	 
	LEON
	 	 	7,000	 
	 
	 	 	 	 
	LIBERTY
	 	 	400	 
	 
	 	 	 	 
	MADISON
	 	 	1,500	 
	 
	 	 	 	 
	MANATEE
	 	 	6,000	 
	 
	 	 	 	 
	MARION
	 	 	20,000	 
	 
	 	 	 	 
	MARTIN
	 	 	5,000	 
	 
	 	 	 	 
	MIAMI-DADE
	 	 	25,000	 
	 
	 	 	 	 
	ORANGE
	 	 	25,000	 
	 
	 	 	 	 
	OSCEOLA
	 	 	8,000	 
	 
	 	 	 	 
	PALM BEACH
	 	 	10,500	 
	 
	 	 	 	 
	PASCO
	 	 	6,000	 
	 
	 	 	 	 
	PINELLAS
	 	 	9,000	 
	 
	 	 	 	 
	POLK
	 	 	10,000	 
	 
	 	 	 	 
	PUTNAM
	 	 	6,000	 
	 
	 	 	 	 
	SANTA ROSA
	 	 	4,000	 
	 
	 	 	 	 
	SARASOTA
	 	 	3,000	 
	 
	 	 	 	 
	SEMINOLE
	 	 	4,000	 
	 
	 	 	 	 
	VOLUSIA
	 	 	15,000	 
	 
	 	 	 	 
	WAKULLA
	 	 	1,000	 
	 
	 	 	 	 

AHCA Contract No. FA521, Amendment No. 8, Page 1 of 6

AHCA Form 2100-0002 (Rcv. NOV03)

HEALTHEASE OF FLORIDA, INC. Medicaid HMO Contract

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

Table 2

Age-banded Capitation Rates for all Agency Areas of the State.

July 1, 2005 through August 31, 2005 — Estimated HMO rates; not for use unless approved by CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 04 General Rates Plan -
	 	 	 	 	 	015019335(VOLUSIA)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	BTHMO+ 2MO 3MO-llMO 1-5	 	6-13 14-20 (F) 14-20(M) 21-54 (F)21-54 (M)
	 	 	 	 	 	 	 	 	 	 	 	 	 		55-64		 		65+		 	 	 	 	 	 	 	 	 	 	 	 
	TANF/FC/SOBRA
	 		877.98		 		175.54		 		86.37       55.47     120.97		 		62.05     234.40		 	 	 	 	 		152.22   317.36		 	 	 	 	 		317.36		 	 	 	 	 	 	 	 
	SSI/No Medicare	 		8571.85		 		1495.58		 	383.99 199.57 218.39 218.39 659.82
	 	 	 	 	 		659.82 620.93		 	 	 	 	 		620.93		 	 	 	 	 	 	 	 
	SSI/Part B333.59	 		333.59		 	333.59 333.59 333.59 333.59 333.59
	 	 	 	 	 		333.59 333.59		 	 	 	 	 		333.59		 	 	 	 	 	 	 	 	 	 	 	 
	SSI/Part A & B	 		294.49		 		294.49		 	294.49 294.49 294.49 294.49 294.49
	 	 	 	 	 		294.49 294.49		 	 	 	 	 		205.57		 	 	 	 	 	 	 	 
	205.57
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 07 General Rates Plan -
	 	 	 	 	 	015019308(BREVARD)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		894.04		 		178.56		 		87.80		 		56.33		 		122.97		 		63.04		 		238.18		 		154.51		 		322.34		 		322.34	
	SSI/No Medicare
	 		8976.51		 		1573.97		 		404.51		 		212.74		 		232.25		 		232.25		 		701.12		 		701.12		 		661.11		 		661.11	
	SSI/Part B
	 		308.90		 		308.90		 		308.90		 		308.90		 		308.90		 		308.90		 		308.90		 		308.90		 		308.90		 		308.90	
	SSI/Part A & B
	 		284.51		 		284.51		 		284.51		 		284.51		 		284.51		 		284.51		 		284.51		 		284.51		 		284.51		 		198.54	
	Area 09 General Rates Plan -	 	 	 	 	 	015019324(MARTIN) 015019339(PALM BEACH)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(P)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		850.65		 		169.56		 		83.32		 		53,28		 		116.63		 		59.62		 		225.69		 		146.30		 		304.86		 		304.86	
	SSI/No Medicare
	 		9123.67		 		1599.06		 		410.92		 		216.11		 		235.92		 		235.92		 		711.70		 		711.70		 		670.95		 		670.95	
	SSI/Part B
	 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69	
	SSI/Part A & B
	 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		221.58	
	Area 10 General Rates Plan -
	 	 	 	 	 	015019337(BROWORD)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		854.17		 		170.86		 		84.11		 		54.07		 		117.82		 		60.56		 		228.53		 		148.48		 		309.80		 		309.80	
	SSI/No Medicare
	 		11134.67		 		1955.18		 		502.14		 		264.85		 		289.15		 		289.15		 		873.08		 		873.08		 		823.33		 		823.33	
	SSI/Part B
	 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19	
	SSI/Part A & B
	 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		238.55	
	Area 11 General Rates plus Transportation

	 	 	 	 	 	Plan - 015019338(DADE)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		1112.08		 		221.47		 		108.96		 		69.38		 		152.49		 		77.84		 		294.30		 		190.48		 		396.50		 		396.50	
	SSI/No Medicare
	 		12145.44		 		2131.38		 		551.08		 		286.49		 		314.89		 		314.89		 		952.30		 		952.30		 		894.10		 		894.10	
	SSI/Part B
	 		455.34		 		455.34		 		455.34		 		455.34		 		455.34		 		455.34		 		455.34		 		455.34		 		455.34		 		455.34	
	SSI/Part A & B
	 		433.96		 		433.96		 		433.96		 		433.96		 		433.96		 		433.96		 		433.96		 		433.96		 		433.96		 		299.72	

September 1, 2005 through December 3 l, 2005 — Estimated HMO rates; not for use unless

approved by CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 04 General Rates Plan -

	 	015019335(VOLUSIA)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		877.98		 		175.54		 		86.37		 		55.47		 		120.97		 		62.05		 		234.40		 		152.22		 		317.36		 		317.36	
	SSI/No Medicare
	 		8571.85		 		1495.58		 		383.99		 		199.57		 		218.39		 		218.39		 		659.82		 		659.82		 		620.93		 		620.93	
	SSI/Part B
	 		333.59		 		333.59		 		333.59		 		333.59		 		333.59		 		333.59		 		333.59		 		333.59		 		333.59		 		333.59	
	SSI/Part A & B
	 		294.49		 		294.49		 		294.49		 		294.49		 		294.49		 		294.49		 		294.49		 		294.49		 		294.49		 		205.57	
	Area 09 General Rates Plan -
	 	015019324(MARTIN) 015019339(PALM BEACH)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		850.65		 		169.56		 		83.32		 		53.28		 		116.63		 		59.62		 		225.69		 		146.30		 		304.86		 		304.86	
	SSI/No Medicare
	 		9123.67		 		1599.06		 		410.92		 		216.11		 		235.92		 		235.92		 		711.70		 		711.70		 		670.95		 		670.95	
	SSI/Part B
	 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69		 		288.69	
	SSI/Part A & B
	 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		317.25		 		221.58	
	Area 10 General Rates Plan -

	 	015019337(BROWARD)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		854.17		 		170.86		 		84.11		 		54.07		 		117.82		 		60.56		 		228.53		 		148.48		 		309.80		 		309.80	
	SSI/No Medicare
	 		11134.67		 		1955.18		 		502.14		 		264.85		 		289.15		 		289.15		 		873.08		 		873.08		 		823.33		 		823.33	
	SSI/Part B
	 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19		 		316.19	
	SSI/Part A & B
	 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		341.03		 		238.55	

January 1, 2006 through June 30, 2006 — Estimated HMO rates; not for use unless approved by

CMS.

AHCA Contract No. FA521, Amendment No. 8, Page 2 of 6

AHCA Form 2100-0002 (Rev. NOV03)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	HEALTHEASE OF FLORIDA, INC.	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicaid HMO Contract	 	 	 	 	 	 	 	 
	Area 04 General Rates Plan -

	 	015019335(VOLUSIA)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		877.98		 		175.54		 		86.37		 		55.47		 		120.97		 		62.05		 		234.40		 		152.22		 		317.36		 		317.36	
	SSI/No Medicare
	 		8571.85		 		1495.58		 		383.99		 		199.57		 		218.39		 		218.39		 		659.82		 		659.82		 		620.93		 		620.93	
	SSI/Part B
	 		207.10		 		207.10		 		207.10		 		207.10		 		207.10		 		207.10		 		207.10		 		207.10		 		207.10		 		207.10	
	SSI/Part A & B
	 		77.20		 		77.20		 		77.20		 		77.20		 		77.20		 		77.20		 		77.20		 		77.20		 		77.20		 		67.39	
	Area 09 General Rates Plan -
	 	015019324(MARTIN) 015019339(PALM BEACH)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		850.65		 		169.56		 		83.32		 		53.28		 		116.63		 		59.62		 		225.69		 		146.30		 		304.86		 		304.86	
	SSI/No Medicare
	 		9123.67		 		1599.06		 		410.92		 		216.11		 		235.92		 		235.92		 		711.70		 		711.70		 		670.95		 		670.95	
	SSI/Part B
	 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44		 		179.44	
	SSI/Part A & B
	 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		76.11		 		66.48	
	Area 10 General Rates Plan -

	 	015019337(BROWARD)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	T/~NF/FC/SOBRA
	 		854.17		 		170.86		 		84.11		 		54.07		 		117.82		 		60.56		 		228.53		 		148.48		 		309.80		 		309.80	
	SSI/No Medicare
	 		11194.67		 		1955.18		 		502.14		 		264.88		 		289.15		 		289.15		 		873.08		 		873.08		 		823.93		 		823.33	
	SSI/Part B
	 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90		 		205.90	
	SSI/Part A & B
	 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		81.99		 		71.59	

4. Attachment I, section 90.0, Payment and Authorized Enrollment Levels, Table 3 is hereby
amended to

now read as follows:

Table 3

Age-banded Capitation Rates for all Agency Areas of the State.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 01 General Rates plus Mental Health
	 	 	 	 	 	Plan — O15019314 (ESCAMBIA) 015019331(SANTA ROSA)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		856.86		 		169.64		 		84.58		 		64.23		 		128.66		 		71.38		 		227.66		 		148.26		 		303.38		 		303.38	
	SSI/No Medicare
	 		8379.21		 		1456.20		 		384.40		 		263.28		 		284.40		 		284.40		 		732.06		 		732.06		 		631.82		 		631.82	
	SSI/Part B
	 		367.49		 		367.49		 		367.49		 		367.49		 		367.49		 		367.49		 		367.49		 		367.49		 		367.49		 		367.49	
	SSI/Part A & B
	 		331.54		 		331.54		 		331.54		 		331.64		 		331.54		 		331.54		 		331.54		 		331.54		 		331.54		 		236.11	

Area 02 General Rates plus Mental Health Plan — 015Ol9315 (GADSDEN) 015019318(JEFFERSON)
015019320(LEON) 015019322(MADISON) 015019336(WAKULLA) 015019340 (CALHOUN) 015019342 (LIBERTY)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	856.87	 	 	 	169.66	 	 	 	85.36	 	 	 	69.25	 	 	 	128.93	 	 	 	71.65	 	 	 	226.56	 	 	 	147.16	 	 	 	302.78	 	 	 	302.78	 
	SSI/No Medicare
	 	 	8379.20	 	 	 	1456.19	 	 	 	388.93	 	 	 	278.27	 	 	 	264.36	 	 	 	264.36	 	 	 	690.25	 	 	 	690.25	 	 	 	621.15	 	 	 	621.15	 
	SSI/Part B
	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 
	SSI/Part A & B
	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.99	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	232.96	 
	Area 03 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015019309(CITRUS) 015019319(LAKE) 015019323 (MARION) 015019329(PUTNAM)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-8	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-84	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	956.51	 	 	 	190.37	 	 	 	94.52	 	 	 	67.12	 	 	 	136.49	 	 	 	72.38	 	 	 	254.10	 	 	 	164.92	 	 	 	342.33	 	 	 	342.33	 
	SSI/No Medicare
	 	 	8796.56	 	 	 	1536.63	 	 	 	401.17	 	 	 	243.67	 	 	 	248.87	 	 	 	248.87	 	 	 	702.91	 	 	 	702.91	 	 	 	649.30	 	 	 	649.30	 
	SSI/Part B
	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 
	SSI/Part A & B
	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	211.35	 
	Area 04 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015019313(DUVAL)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	877.99	 	 	 	175.55	 	 	 	87.56	 	 	 	63.92	 	 	 	127.39	 	 	 	68.47	 	 	 	235.93	 	 	 	153.75	 	 	 	318.93	 	 	 	318.93	 
	SSI/NO Medicare
	 	 	8571.86	 	 	 	1495.59	 	 	 	394.00	 	 	 	254.46	 	 	 	252.62	 	 	 	252.62	 	 	 	694.02	 	 	 	694.02	 	 	 	635.24	 	 	 	635.24	 
	SSI/Part B
	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 
	SSI/Part A & B
	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	223.04	 
	Area 05 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015019302(PASCO)	 	015019303(PINELLAS)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	919.98	 	 	 	183.43	 	 	 	91.15	 	 	 	64.87	 	 	 	131.62	 	 	 	69.93	 	 	 	245.33	 	 	 	159.49	 	 	 	331.03	 	 	 	331.03	 
	SSI/No Medicare
	 	 	9248.02	 	 	 	1615.41	 	 	 	420.86	 	 	 	252.27	 	 	 	258.55	 	 	 	258.55	 	 	 	735.80	 	 	 	735.80	 	 	 	681.19	 	 	 	681.19	 
	SSI/Part B
	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 
	SSI/Part A & B
	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	227.10	 

Area 06 General Rates plus Mental Health Plan — 015019300(HILLSBOROUGH) 015019301(MANATEE)
015019304(POLK) 015019317 (HIGHLANDS)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	839.91	 	 	 	168.14	 	 	 	84.80	 	 	 	67.94	 	 	 	131.59	 	 	 	75.16	 	 	 	230.12	 	 	 	151.25	 	 	 	309.66	 	 	 	309.66	 
	SSI/No Medicare
	 	 	8636.50	 	 	 	1494.29	 	 	 	393.28	 	 	 	262.75	 	 	 	284.04	 	 	 	284.04	 	 	 	746.59	 	 	 	746.59	 	 	 	653.76	 	 	 	653.76	 
	SSI/Part B
	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 
	SSI/Part A & B
	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	202.46	 

AHCA Contract No. FA521, Amendment No. 8, Page 3 of 6

AHCA Form 2100-0002 (Rev. NOV03)

1

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	HEALTHEASE OF FLORIDA, INC.	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicaid HMO Contract	 	 	 	 	 	 	 	 
	Area 07 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015019327(ORANGE)	 	015019328(OSCEOLA)	 	 	 	 	 	 	 	 	 	015019333(SEMINOLE)	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		894.05		 		178.57		 		89.54		 		68.64		 		132.32		 		72.39		 		240.41		 		156.74		 		324.62		 		324.62	
	SSI/No Medicare
	 		8976.52		 		1573.98		 		414.04		 		264.97		 		264.82		 		264.82		 		733.66		 		733.66		 		674.72		 		674.72	
	SSI/Part B
	 		312.78		 		312.78		 		312.78		 		312.78		 		312.78		 		312.78		 		312.78		 		312.78		 		312.78		 		312.78	
	SSI/Part A & B
	 		296.22		 		296.22		 		296.22		 		296.22		 		296.22		 		296.22		 		296.22		 		296.22		 		296.22		 		210.25	
	Area 08 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015019332(SARASOTA)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 		1-5		 		6-13		 		14-20	(F)	 		14-20	(M)	 		21-54	(F)	 		21-54	(M)	 		55-64		 		65+	
	TANF/FC/SOBRA
	 		785.53		 		156.86		 		78.13		 		56.61		 		113.39		 		60.74		 		210.44		 		136.92		 		284.23		 		284.23	
	SSI/No Medicare
	 		8247.94		 		1440.21		 		376.25		 		229.28		 		234.06		 		234.06		 		659.32		 		659.32		 		608.59		 		608.59	
	SSI/Part B
	 		313.20		 		313.20		 		313.20		 		313.20		 		313.20		 		313.20		 		313.20		 		313.20		 		313.20		 		313.20	
	SSI/Part A & B
	 		297.40		 		297.40		 		297.40		 		297.40		 		297.40		 		297.40		 		297.40		 		297.40		 		297.40		 		210.20	

September 1, 2005 through December 31, 2005 — Estimated HMO rates; not for use unless approved
by CMS.

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

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(P)	 	 	14-20	(M)	 	 	21-54	(P)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	856.86	 	 	 	169.64	 	 	 	84.58	 	 	 	64.23	 	 	 	128.66	 	 	 	71.38	 	 	 	227.66	 	 	 	148.26	 	 	 	303.38	 	 	 	303.38	 
	SSI/NO Medicare
	 	 	8379.21	 	 	 	1456.20	 	 	 	384.40	 	 	 	263.28	 	 	 	284.40	 	 	 	284.40	 	 	 	732.06	 	 	 	732.06	 	 	 	631.82	 	 	 	631.82	 
	SSI/Part B
	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 	 	 	367.49	 
	SSI/Part A & B
	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	331.54	 	 	 	236.11	 

Area 02 General Rates plus Mental Health Plan — 015019315(GADSDEN) 015019318(JEFFERSON)
015019320(LEON) 015019322(MADISON) 015019336(WAKULLA) 015019340(CALHOUN)
015019342(LIBERTY)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	856.87	 	 	 	169.65	 	 	 	85.36	 	 	 	69.25	 	 	 	128.93	 	 	 	71.65	 	 	 	226.56	 	 	 	147.16	 	 	 	302.78	 	 	 	302.78	 
	SSI/No Medicare
	 	 	8379.20	 	 	 	1456.19	 	 	 	388.93	 	 	 	278.27	 	 	 	264.36	 	 	 	264.36	 	 	 	690.25	 	 	 	690.25	 	 	 	621.15	 	 	 	621.15	 
	SSI/Part B
	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 	 	 	380.79	 
	SSI/Part A & B
	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	328.39	 	 	 	232.96	 

Area 03 General Rates plus Mental Health Plan — 015019309(CITRUS) 015019319(LAKE) 015019323(MARION)
O15019329 (PUTNAM)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(P)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/PC/SOBRA
	 	 	956.51	 	 	 	190.37	 	 	 	94.52	 	 	 	67.12	 	 	 	136.49	 	 	 	72.38	 	 	 	254,10	 	 	 	164.92	 	 	 	342.33	 	 	 	342.33	 
	SSI/NO Medicare
	 	 	8796.56	 	 	 	1536.63	 	 	 	401.17	 	 	 	243.67	 	 	 	248.87	 	 	 	248.87	 	 	 	702.91	 	 	 	702.91	 	 	 	649.30	 	 	 	649.30	 
	SSI/Part B
	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 	 	 	356.54	 
	SSI/Part A & B
	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	299.65	 	 	 	211.35	 

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

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	877.99	 	 	 	175.55	 	 	 	87.56	 	 	 	63.92	 	 	 	127.39	 	 	 	68.47	 	 	 	235.93	 	 	 	153.75	 	 	 	318.93	 	 	 	318.93	 
	SSI/NO Medicare
	 	 	8571.86	 	 	 	1495.59	 	 	 	394.00	 	 	 	254.46	 	 	 	252.62	 	 	 	252.62	 	 	 	694.02	 	 	 	694.02	 	 	 	635.24	 	 	 	635.24	 
	SSI/Part B
	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 	 	 	342.17	 
	SSI/Part A & B
	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	311.96	 	 	 	223.04	 

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

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHM0+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	919.98	 	 	 	183.43	 	 	 	91.15	 	 	 	64.87	 	 	 	131.62	 	 	 	69.93	 	 	 	245.33	 	 	 	159.49	 	 	 	331.03	 	 	 	331.03	 
	SSI/NO Medicare
	 	 	9248.02	 	 	 	1615.41	 	 	 	420.86	 	 	 	252.27	 	 	 	258.55	 	 	 	258.55	 	 	 	735.80	 	 	 	735.80	 	 	 	681.19	 	 	 	681.19	 
	SSI/Part B
	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 	 	 	332.63	 
	SSI/Part A & B
	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321.24	 	 	 	321,24	 	 	 	321.24	 	 	 	321.24	 	 	 	227.10	 

Area 06 General Rates plus Mental Health Plan — 015019300(HILLSBOROUGH) 015019301(MANATEE)
015019304(POLK) 015019317(HIGHLANDS)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	839.91	 	 	 	168.14	 	 	 	84.80	 	 	 	67.94	 	 	 	131.59	 	 	 	75.16	 	 	 	230.12	 	 	 	151.25	 	 	 	309.66	 	 	 	309.66	 
	SSI/No Medicare
	 	 	8536.50	 	 	 	1494.29	 	 	 	393.28	 	 	 	262.75	 	 	 	284.04	 	 	 	284.04	 	 	 	746.59	 	 	 	746.59	 	 	 	653.76	 	 	 	653.76	 
	SSI/Part B
	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 	 	 	319.38	 
	SSI/Part A & B
	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	288.23	 	 	 	202.46	 

Area 07 General Rates plus Mental Health Plan — 015019308(BREVARD) 015019327(ORANGE)
015019328(OSCEOLA) 015019333(SEMINOLE)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	894.05	 	 	 	178.57	 	 	 	89.54	 	 	 	68.64	 	 	 	132.32	 	 	 	72.39	 	 	 	240.41	 	 	 	156.74	 	 	 	324.62	 	 	 	324.62	 
	SSI/NO Medicare
	 	 	8976.52	 	 	 	1573.98	 	 	 	414.04	 	 	 	264.97	 	 	 	264.82	 	 	 	264.82	 	 	 	733.66	 	 	 	733.66	 	 	 	674.72	 	 	 	674.72	 
	SSI/Part B
	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 	 	 	312.78	 
	SSI/Part A & B
	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	296.22	 	 	 	210.25	 

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

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	785.53	 	 	 	156.86	 	 	 	78.13	 	 	 	56.61	 	 	 	113.39	 	 	 	60.74	 	 	 	210.44	 	 	 	136.92	 	 	 	284.23	 	 	 	284.23	 
	SSI/NO Medicare
	 	 	8247,94	 	 	 	1440.21	 	 	 	376.25	 	 	 	229.28	 	 	 	234.06	 	 	 	234.06	 	 	 	659.32	 	 	 	659.32	 	 	 	608.59	 	 	 	608.59	 
	SSI/Part B
	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20    313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	313.20	 	 	 	 	 
	SSI/Part A & B
	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	297.40	 	 	 	210.20	 

AHCA Contract No. FA521, Amendment No. 8, Page 4 of 6

AHCA Form 2100-0002 (Rev. NOV03)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	HEALTHEASE OF FLORIDA, INC.	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Medicaid HMO Contract	 	 	 	 	 	 	 	 
	Area 11General Rates plus Mental Health plus Transportation Plan - 015019338(DADE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	1112.09	 	 	 	221.48	 	 	 	110.76	 	 	 	82.14	 	 	 	162.18	 	 	 	87.53	 	 	 	296.62	 	 	 	192.80	 	 	 	398.87	 	 	 	398.87	 
	SSI/No Medicare
	 	 	12145.45	 	 	 	2131.39	 	 	 	560.13	 	 	 	336.09	 	 	 	345.82	 	 	 	345.82	 	 	 	983.20	 	 	 	983.20	 	 	 	907.03	 	 	 	907.03	 
	SSI/Part B
	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 	 	 	462.31	 
	SSI/Part A & B
	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	439.76	 	 	 	305.52	 

January 1, 2006 through June 30, 2006 — Estimated HMO rates; not for use unless approved by
CMS.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	Area 01 General Rates plus Mental Health Plan - 015019314(ESCAMBIA) 015019331(SANTA ROSA)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54(F)    21-54	(M)	 	 	55-64        65+	 	 	 	 	 	 	 	 	 
	TANF/FC/SOBRA
	 	 	856.86	 	 	 	169.64	 	 	 	84.58	 	 	 	64.23	 	 	 	128.66	 	 	 	71.38	 	 	 	227.66	 	 	 	148.26	 	 	 	303.38	 	 	 	303.38	 
	SSI/NO Medicare
	 	 	8379.21	 	 	 	1456.20	 	 	 	384.40	 	 	 	263.28	 	 	 	284.40	 	 	 	284.40	 	 	 	732.06	 	 	 	732.06	 	 	 	631.82	 	 	 	631.82	 
	SSI/Part B
	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 	 	 	221.62	 
	SSI/Part A & B
	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	94.39	 	 	 	84.53	 

Area 02 General Rates plus Mental Health Plan — 015019315(GADSDEN) 015019318 (JEFFERSON)
015019320 (LEON) 015019322(MADISON) 015019336(WAKULLA) 015019340(CALHOUN)
015019342(LIBERTY)

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	856.87	 	 	 	169.65	 	 	 	85.36	 	 	 	69.25	 	 	 	128.93	 	 	 	71.65	 	 	 	226.56	 	 	 	147.16	 	 	 	302.78	 	 	 	302.78	 
	SSI/No Medicare
	 	 	8379.20	 	 	 	1456.19	 	 	 	388.93	 	 	 	278.27	 	 	 	264.38	 	 	 	264.36	 	 	 	690.25	 	 	 	690.25	 	 	 	621.15	 	 	 	621.15	 
	SSI/Part B
	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 	 	 	234.92	 
	SSI/Part A & B
	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	91.24	 	 	 	81.38	 
	Area 03 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015019309(CITRUS) 015019319(LAKE) 015019323 (MARION) 015019329(PUTNAM)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	956.51	 	 	 	190.37	 	 	 	94.52	 	 	 	67.12	 	 	 	136.49	 	 	 	72.38	 	 	 	254.10	 	 	 	164.92	 	 	 	342.33	 	 	 	342.33	 
	SSI/No Medicare
	 	 	8796.56	 	 	 	1536.63	 	 	 	401.17	 	 	 	243.67	 	 	 	248.87	 	 	 	248.87	 	 	 	702.91	 	 	 	702.91	 	 	 	649.30	 	 	 	649.30	 
	SSI/Part B
	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 	 	 	237.65	 
	SSI/Part A & B
	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	83.24	 	 	 	73.70	 
	Area 04 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015019313 (DUVAL)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	877.99	 	 	 	175.55	 	 	 	87.56	 	 	 	63.92	 	 	 	127.39	 	 	 	68.47	 	 	 	235.93	 	 	 	153.75	 	 	 	318.93	 	 	 	318.93	 
	SSI/No Medicare
	 	 	8571.86	 	 	 	1495.59	 	 	 	394.00	 	 	 	254.46	 	 	 	252.62	 	 	 	252.62	 	 	 	694.02	 	 	 	694.02	 	 	 	635.24	 	 	 	635.24	 
	SSI/Part B
	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 	 	 	215.68	 
	SSI/Part A & B
	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	94.67	 	 	 	84.86	 
	Area 05 General Rates plus Mental Health

	 	 	 	 	 	Plan - 015019302(PASCO)	 	015019303(PINELLAS)	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	919.98	 	 	 	183.43	 	 	 	91.15	 	 	 	64.87	 	 	 	131.62	 	 	 	69.93	 	 	 	245.33	 	 	 	159.49	 	 	 	331.03	 	 	 	331.03	 
	SSI/No Medicare
	 	 	9248.02	 	 	 	1615.41	 	 	 	420.86	 	 	 	252.27	 	 	 	258.55	 	 	 	258.55	 	 	 	735.80	 	 	 	735.80	 	 	 	681.19	 	 	 	681.19	 
	SSI/Part B
	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 	 	 	214.59	 
	SSI/Part A & B
	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	83.91	 	 	 	74.53	 
	Area 06 General Rates plus Mental Health
	 	Plan - 015019300(HILLSBOROUGH) 015019301(MANATEE) 015019304(POLK) 015019317(HIGHLANDS)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	839.91	 	 	 	168.14	 	 	 	84.80	 	 	 	67.94	 	 	 	131.59	 	 	 	75.16	 	 	 	230.12	 	 	 	151.25	 	 	 	309.66	 	 	 	309.66	 
	SSI/No Medicare
	 	 	8536.50	 	 	 	1494.29	 	 	 	393.28	 	 	 	282.75	 	 	 	284.04	 	 	 	284.04	 	 	 	746.59	 	 	 	746.59	 	 	 	653.76	 	 	 	653.76	 
	SSI/Part B
	 	 	201.26	 	 	 	201,26	 	 	 	201.26	 	 	 	201.26	 	 	 	201.26	 	 	 	201.26	 	 	 	201.26	 	 	 	201.26	 	 	 	201.26	 	 	 	201.26	 
	SSI/Part A & B
	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	73.23	 	 	 	64.45	 
	Area 07 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015019308 (BREVA—D) O15019327 (ORANGE) 015019328(OSCEOLA) 015019333 (SEMINOLE)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	894.05	 	 	 	178.57	 	 	 	89.54	 	 	 	68.64	 	 	 	132.32	 	 	 	72.39	 	 	 	240.41	 	 	 	156.74	 	 	 	324.62	 	 	 	324.62	 
	SSI/No Medicare
	 	 	8976.52	 	 	 	1573.98	 	 	 	414.04	 	 	 	264.97	 	 	 	264.82	 	 	 	264.82	 	 	 	733.66	 	 	 	733.66	 	 	 	674.72	 	 	 	674.72	 
	SSI/Part B
	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 	 	 	203.20	 
	SSI/Part A & B
	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	84.13	 	 	 	74.97	 
	Area 08 General Rates plus Mental Health
	 	 	 	 	 	Plan - 015019332(SARASOTA)
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	785.53	 	 	 	156.86	 	 	 	78.13	 	 	 	56.61	 	 	 	113.39	 	 	 	60.74	 	 	 	210.44	 	 	 	136.92	 	 	 	284.23	 	 	 	284.23	 
	SSI/No Medicare
	 	 	8247.94	 	 	 	1440.21	 	 	 	376.25	 	 	 	229.28	 	 	 	234.06	 	 	 	234.06	 	 	 	659.32	 	 	 	659.32	 	 	 	608.59	 	 	 	608.59	 
	SSI/Part B
	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 	 	 	191.91	 
	SSI/Part A & B
	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	77.95	 	 	 	69.13	 

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

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	BTHMO+2MO
	 	3MO-11MO	 	 	1-5	 	 	 	6-13	 	 	 	14-20	(F)	 	 	14-20	(M)	 	 	21-54	(F)	 	 	21-54	(M)	 	 	55-64	 	 	 	65+	 
	TANF/FC/SOBRA
	 	 	1112.09	 	 	 	221.48	 	 	 	110.76	 	 	 	82.14	 	 	 	162.18	 	 	 	87.53	 	 	 	296.62	 	 	 	192.80	 	 	 	398.87	 	 	 	398.87	 
	SSI/No Medicare
	 	 	12145.45	 	 	 	2131.39	 	 	 	560.13	 	 	 	336.09	 	 	 	345.82	 	 	 	345.82	 	 	 	983.20	 	 	 	983.20	 	 	 	907.03	 	 	 	907.03	 
	SSI/Part B
	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 	 	 	280.88	 
	SSI/Part A & B
	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	131.46	 	 	 	109.55	 

AHCA Contract No. FA521, Amendment No. 8, Page 5 of 6

AHCA Form 2100-0002 (Rev. NOV03)

HEALTHEASE OF FLORIDA, INC. Medicaid HMO Contract

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

Notwithstanding the payment amounts which may be computed with the above rate table, the sum of
total capitation payments under this contract shall not exceed the total contract amount of
$833,550,430.00 (an increase of $12,618,094.00) expressed on page seven of this contract.

	 	6.	 	This amendment shall begin on September 1, 2005, or the date on which the amendment has been
signed by both parties, whichever is later.

All provisions in the Contract and any attachments thereto in conflict with this amendment
shall be and are hereby changed to conform with this amendment.

All provisions not in conflict with this amendment are still in effect and are to be performed
at the level specified in the Contract.

This amendment and all its attachments are hereby made a part of the Contract.

This amendment cannot be executed unless all previous amendments to this Contract have been
fully executed.

IN WITNESS WHEREOF, the parties hereto have caused this 6 page amendment (including all
attachments) to be executed by their officials thereunto duly authorized.

HEALTHEASE OF FLORIDA, INC. STATE OF FLORIDA, AGENCY FOR

HEALTH CARE ADMINISTRATION

	 	 	 
	SIGNED

BY:/s/ Todd S. Farha     

	 	SIGNED

BY:     [Illegible]     
	 

	 	 

NAME: Todd S. Farha 
NAME: Alan Levine 

	 	 	 	 	 
	TITLE: President & CEO

	 	TITLE: Secretary
	 	

	 
	 	 	 	 
	 	 	 

	 
	 	 	 	 
	DATE: 8/31/05

	 	DATE:
	 	9/1/05
	 

	 	 	 	 

THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY

AHCA Contract No. FA521, Amendment No. 8, Page 6 of 6

AHCA Form 2100-0002 (Rev. NOV03)

2

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00091-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00091-of-00352.parquet"}]]