Document:

exv10w5

Exhibit 10.5

AMENDMENT #4 TO CONTRACT NO. 0652 BETWEEN

GEORGIA DEPARTMENT OF COMMUNITY HEALTH AND

AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.

     This Amendment is between the Georgia Department of Community Health (hereinafter referred to
as “DCH” or the “Department”) and Amerigroup Georgia Managed Care Company, Inc. (hereinafter
referred to as “Contractor”) and is made effective this  26th day of

August, 2008 (hereinafter referred to as the “Effective Date”). Other than the chands,
modifications and additions specifically articulated in this Amendment #3 to Contract # 0652,
RFP#41900-001-0000000027, the original Contract shall remain in effect and binding on and against
DCH and Contractor. Unless expressly modified or added in this Amendment #4, the terms and
conditions of the original Contract are expressly incorporated into this Amendment #4 as if
completely restated herein.

     WHEREAS, DCH and Contractor executed a contract for the provision of services to Georgia
Healthy Families; and,

     WHEREAS, pursuant to Section 32.0, Amendments in Writing, DCH and Contractor desire to amend
the above-referenced Contract as set forth below.

     NOW THEREFORE, for and in consideration of the mutual promisesof the Parties, the terms,
provisions and conditions of this Amendment and other good and valuable consideration, the
sufficiency of which is hereby acknowledged, DCH and Contractor hereby agree as follows:

	I.	 	To delete the current Section 26.0 PAYMENT BOND & IRREVOCABLE LETTER
OF CREDIT in its entirety and replace with the following:

26.0 PAYMENT BOND & IRREVOCABLE LETTER OF CREDIT

				
		Section 26.1	 	Within five (5) Business Days of Contract Execution, Contractor
shall obtain and maintain in force and effect an irrevocable letter of
credit in the amount representing one half of one month’s total Net
Capitation Payment associated with the actual GCS lives enrolled in
Contractor’s plan. On or before July 2 each following year, Contractor
shall modify the amount of the irrevocable letter of credit currently
in force and effect to equal one-half of the average of the Net
Capitation Payments paid to the Contractor for the months of January,
February and March. If at any time during the year, the actual GCS
lives enrolled in Contractor’s plan increases or decreases by more
than twenty-five percent, DCH, at it sole discretion, may increase or
decrease the amount required for the irrevocable letter of credit.

Notwithstanding the above, in the event that the amount of the
irrevocable letter of credit required hereunder would exceed

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$17,365,640.00, Contractor shall have the option, in its discretion, to obtain a surety bond in
lieu of the irrevocable letter of credit for any amounts in excess of $17,365,640.00, and such
surety bond, together with an irrevocable letter of credit in the amount of $17,365,640.00, shall
satisfy Contractor’s obligations under this Section 26.1.

With regard to the irrevocable letter of credit, DCH may recoup payments from the Contractor
for liabilities or obligations arising from any act, event, omission or condition which occurred
or existed subsequent to the effective date of the Contract and which is identified in a survey,
review, or audit conducted or assigned by DCH. 

			
	Section 26.2	 	DCH may also, at its discretion, redeem Contractor’s irrevocable
letter of credit in the amount(s) of actual damages suffered by DCH if DCH
determines that the Contractor is (1) unable to perform any of the terms and
conditions of the Contract or if (2) the Contractor is terminated by default or
bankruptcy or material breach that is not cured within the time specified by
DCH, or under both conditions described at one (1) and two (2).

			
	Section 26.3	 	During the Contract period, Contractor shall obtain
and maintain a payment bond from an entity licensed
to do business in the State of Georgia and acceptable
to DCH with sufficient financial strength and
creditworthiness to assume the payment obligations of
Contractor in the event of a default in payment
arising from bankruptcy, insolvency, or other cause.
Said bond shall be delivered to DCH within five (5)
Business Days of Contract Execution and shall be in
the amount of Five Million Dollars ($5,000,000.00).
On or before July 2, of each following year,
Contractor shall modify the amount of the bond to
equal the average of the Net Capitation Payments paid
to the Contractor for the months of January, February
and March.

If at any time during the year, the actual GCS lives enrolled in
Contractor’s plan increases or decreases by more than twenty-five percent,
DCH, at its sole discretion, may increase or decrease the amount required
for the bond.

	II.	 	DCH and Contractor agree that they have assumed an obligation to perform the covenants,
agreements, duties and obligations of the Contract, as modified and amended herein, and agree
to abide by all the provisions, terms and conditions contained in the Contract as modified and
amended.

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	III.	 	This Amendment shall be binding and inure to the benefit of the parties hereto, their
heirs, representatives, successors and assigns. Whenever the provisions of this Amendment and
the Contract are in conflict, the provisions of this Amendment shall take precedence and
control.
	 
	VI.	 	It is understood by the Parties hereto that, if any part, term, or provision of this Amendment or this entire Amendment
is held to be illegal or in conflict with any law of this State, then DCH, at its sole option, may enforce the remaining
unaffected portions or provisions of this Amendment or of the Contract and the rights and obligations of the parties
shall be construed and enforced as if the Contract or Amendment did not contain the particular part, term or provision
held to be invalid.
	 
	VII.	 	This Amendment shall become effective as stated herein and shall remain effective for so long as the Contract is in
effect.
VIII. This Amendment shall be construed in accordance with the laws of the State of Georgia.
	 
	IX.	 	All other terms and conditions contained in the Contract and any amendment thereto, not amended by this Amendment, shall
remain in full force and effect.

- SIGNATURES ON THE FOLLOWING PAGE -

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GEORGIA DEPARTMENT OF COMMUNITY HEALTH

	 	 	 
	/s/ Dr. Rhonda M. Medows
	 	 
	 

Dr. Rhonda M. Medows, M.D.

	 	 Date
8/26/08
	Commissioner
	 	 

AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.

	 	 	 	 	 	 	 
	BY:

	 	/s/ Melvin Lindsey
	 	Date 5/29/08	 	 
	 

	 	 

*SIGNATURE
	 	 	 	 
	 
	 	 	 	 	 	 
	 

	 	 

Please Print/Type Name Here)
	 	 	 	 
	 
	 	 	 	 	 	 
	 

	 	 	 	 

AFFIX CORPORATE SEAL HERE 

(Corporations
without a seal, attach
a Certificate of 

Corporate Resolution)

	 
	 	 	 	 	 	 
	ATTEST:

	 	/s/ Stanley F. Baldwin	 	 	 	 
	 

	 	 	 	 	 	 
	 

	 	**SIGNATURE	 	 	 	 
	 
	 	 	 	 	 	 
	 

	 	Corporate Secretary	 	 	 	 
	 

	 	TITLE	 	 	 	 

 

			
	*	 	Must be President, Vice President, CEO or Other Authorized Officer
	 
	**	 	Must be Corporate Secretary

Page 4 of 4exv10w6

Exhibit 10.6

AMENDMENT #5 TO CONTRACT NO. 0652 BETWEEN

GEORGIA DEPARTMENT OF COMMUNITY HEALTH AND

AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.

     This Amendment is between the Georgia Department of Community Health (hereinafter referred
to as “DCH” or the “Department”) and Amerigroup Georgia Managed Care Company,
(hereinafter referred to as “Contractor”) and is made effective this 15th day of
September, 2008 (hereinafter referred to as the “Effective Date”). Other than
the changes, modifications and additions specifically articulated in this Amendment #5 to
Contract # 0652, RFP#41900-001-0000000027, the original Contract shall remain in effect and
binding on and against DCH and Contractor. Unless expressly modified or added in this Amendment
#5, the terms and conditions of the original Contract are expressly incorporated into this
Amendment #5 as if completely restated herein.

     WHEREAS, DCH and Contractor executed a contract for the provision of services to members of
the Georgia Families Program;

     WHEREAS, DCH pays Contractor a per member per month capitation rate for each Georgia
Families member enrolled in the Contractor’s plan;

     WHEREAS, DCH has sought permission from the Centers for Medicare and Medicaid Services
(hereinafter referred to as “CMS”) to revise the capitation rates payable to Contractor for
State Fiscal Year 2009; and

     WHEREAS, pursuant to Section 32.0, Amendments in Writing, DCH and Contractor desire to
amend the above-referenced Contract by adding additional funding as set forth below.

     NOW THEREFORE, for and in consideration of the mutual promises of the Parties, the terms,
provisions and conditions of this Amendment and other good and valuable consideration, the
sufficiency of which is hereby acknowledged, DCH and Contractor hereby agree as follows:

	I.	 	Upon receiving written notice from CMS indicating that agency’s approval of the revised
capitation rates, the parties shall delete the current Attachment H, Capitation Payment, in
its entirety and replace it with the new Attachment H, Capitation Payment, contained at
Exhibit 1 to this Amendment.
	 
	II.	 	DCH and Contractor agree that they have assumed an obligation to perform the covenants,
agreements, duties and obligations of the Contract, as modified and amended herein, and
agree to abide by all the provisions, terms and conditions contained in the Contract as
modified and amended.
	 
	III.	 	This Amendment shall be binding and inure to the benefit of the parties hereto, their
heirs, representatives, successors and assigns. Whenever the provisions of this Amendment
and the Contract are in conflict, the provisions of this Amendment shall take precedence
and control.

 Page 1 of 4

 

	VI.	 	It is understood by the Parties hereto that, if any part, term, or
provision of this Amendment or this entire Amendment is held to be
illegal or in conflict with any law of this State, then DCH, at its
sole option, may enforce the remaining unaffected portions or
provisions of this Amendment or of the Contract and the rights and
obligations of the parties shall be construed and enforced as if the
Contract or Amendment did not contain the particular part, term or
provision held to be invalid.
	 
	VII.	 	This Amendment shall become effective as stated herein and shall
remain effective for so long as the Contract is in effect.
	 
	VIII.	 	This Amendment shall be construed in accordance with the laws of the
State of Georgia.
	 
	IX.	 	All other terms and conditions contained in the Contract and any
amendment thereto, not amended by this Amendment, shall remain in
full force and effect.

- SIGNATURES ON THE FOLLOWING PAGE -

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SIGNATURE PAGE

IN WITNESS WHEREOF, DCH and Contractor, through their authorized officers and agents, have caused
this Amendment to be executed on their behalf as of the date indicated.

GEORGIA DEPARTMENT OF COMMUNITY HEALTH

	 	 	 
	/S/ Dr. Rhonda M. Medows, M.D.

	 	Date

	 

Commssioner

	 	 

AMERIGROUP GEORGIA MANAGED CARE COMPANY, INC.

	 	 	 	 
	BY:
 
	 	 
	 

	 	 
	 

	 	Date	 
	 
 
	 	 

	 	 	 	 	 
	/S/ Dr,Tunde Sotunde, CEO

	 	 
	 	  
	 

Please Print/Type Name Here

	 	 	 	 
	 
	 	 	 	 
	 

	 	 

AFFIX CORPORATE SEAL HERE (Corporations without
a seal, attach a Certificate of Corporate Resolution

	 	 	 
	 

ATTEST: /S/ Stanley F. Baldwin

	 	 
	TITLE: Secretary
	 	 

 

			
	*	 	Must be President, Vice President, CEO or Other Authorized Officer
	 
	**	 	Must be Corporate Secretary

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EXHIBIT 1

CONFIDENTIAL — NOT FOR CIRCULATION

ATTACHMENT H

Attachment H is a table displaying the contracted rates by rate cell for each contracted region.
These rates will be the basis for calculating capitation payments in each contracted Region.

(The table is displayed on the following page.)

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FY 2009 CMO Rates

	 	 	 	 	 	 	 
	Region	 	Aid Category	 	Age/Gender Group	 	Amerigroup
	Atlanta
	 	Medicaid (LIM/Refugee/RSM)	 	0 - 2 Months, Male and Female	 	****REDACTED***
	Atlanta
	 	 	 	3 - 11 Months, Male and Female	 	 
	Atlanta
	 	 	 	1 - 5 Years, Male and Female	 	 
	Atlanta
	 	 	 	6 -13 Years, Male and Female	 	 
	Atlanta
	 	 	 	14 - 20 Years, Female	 	 
	Atlanta
	 	 	 	14 - 20 Years, Male	 	 
	Atlanta
	 	 	 	21 - 44 Years, Female	 	 
	Atlanta
	 	 	 	21 -44 Years, Male	 	 
	Atlanta
	 	 	 	45+ Years, Female	 	 
	Atlanta
	 	 	 	45+ Years, Male	 	 
	Atlanta
	 	PeachCare	 	0 - 2 Months, Male and Female	 	 
	Atlanta
	 	PeachCare	 	3 - 11 Months, Male and Female	 	 
	Atlanta
	 	PeachCare	 	1 - 5 Years, Male and Female	 	 
	Atlanta
	 	PeachCare	 	6 - 13 Years, Male and Female	 	 
	Atlanta
	 	PeachCare	 	14 - 20 Years, Female	 	 
	Atlanta
	 	PeachCare	 	14 - 20 Years, Male	 	 
	Atlanta
	 	Breast and Cervical Cancer	 	All Ages	 	 
	Atlanta
	 	 	 	 	 	 
	East
	 	 	 	0 - 2 Months, Male and Female	 	 
	East
	 	 	 	3 - 11 Months, Male and Female	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	1 - 5 Years, Male and Female	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	6 - 13 Years, Male and Female	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	14 - 20 Years, Female	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	14 - 20 Years, Male	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	21 -44 Years, Female	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	21 -44 Years, Male	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	45+ Years, Female	 	 
	East
	 	Medicaid (LIM/Refugee/RSM)	 	45+ Years, Male	 	 
	East
	 	PeachCare	 	0 - 2 Months, Male and Female	 	 
	East
	 	PeachCare	 	3 - 11 Months, Male and Female	 	 
	East
	 	PeachCare	 	1 - 5 Years, Male and Female	 	 
	East
	 	PeachCare	 	6 - 13 Years, Male and Female	 	 
	East
	 	PeachCare	 	14 - 20 Years, Female	 	 
	East
	 	PeachCare	 	14 - 20 Years, Male	 	 
	East
	 	Breast and Cervical Cancer	 	All Ages	 	 
	East
	 	Maternity Delivery/Kick Payment	 	 	 	 
	North
	 	 	 	 	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	3 - 11 Months, Male and Female	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	1 - 5 Years, Male and Female  6 - 13	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	Years, Male and Female	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	14 - 20 Years, Female	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	14 - 20 Years, Male	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	21 - 44 Years, Female	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	21 - 44 Years, Male	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	45+ Years, Female	 	 
	North
	 	Medicaid (LIM/Refugee/RSM)	 	45+ Years, Male	 	 
	North
	 	PeachCare	 	0 - 2 Months, Male and Female	 	 
	North
	 	PeachCare	 	3 - 11 Months, Male and Female	 	 
	North
	 	PeachCare	 	1 - 5 Years, Male and Female	 	 
	North
	 	PeachCare	 	6 -13 Years, Male and Female	 	 
	North
	 	PeachCare	 	14 - 20 Years, Female	 	 
	North
	 	PeachCare	 	14 - 20 Years, Male	 	 
	North
	 	Breast and Cervical Cancer	 	All Ages	 	 
	North
	 	Maternity Delivery/Kick Payment	 	 	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	0 - 2 Months, Male and Female	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	3 - 11 Months, Male and Female	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	1 - 5 Years, Male and Female	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	6 - 13 Years, Male and Female	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	14 - 20 Years, Female	 	 
	 
	 	Medicaid (LIM/Refugee/RSM)	 	14 - 20 Years, Male	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	21 - 44 Years, Female	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	 	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	21 - 44 Years, Male 45+ Years, Female	 	 
	Southeast
	 	Medicaid (LIM/Refugee/RSM)	 	45+ Years, Male	 	 
	Southeast
	 	PeachCare	 	0 - 2 Months, Male and Female	 	 
	Southeast
	 	PeachCare	 	3 - 11 Months, Male and Female	 	 
	Southeast
	 	PeachCare	 	1 - 5 Years, Male and Female	 	 
	Southeast
	 	PeachCare	 	6 -13 Years, Male and Female	 	 
	Southeast
	 	PeachCare	 	14 - 20 Years, Female	 	 
	Southeast
	 	PeachCare	 	14 - 20 Years, Male	 	 
	Southeast
	 	Breast and Cervical Cancer	 	All Ages	 	 
	Southeast
	 	Maternity Delivery/Kick Payment

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