Exhibit 10.15
| WellCare of Florida, Inc. | | Medicaid HMO Non-Reform Contract |
| d/b/a Staywell Health Plan of Florida | | |
AHCA CONTRACT NO. FA904
AMENDMENT NO. 6
THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency” and WELLCARE OF FLORIDA, INC. D/B/A STAYWELL HEALTH PLAN OF FLORIDA, hereinafter referred to as the “Vendor” or “Health Plan”, is hereby amended as follows:
| 1. | Effective August 1, 2011, Attachment I, Scope of Services, Capitated Health Plans, is hereby amended to include Attachment I, Exhibit 1-A, Revised Maximum Enrollment Levels, attached hereto and made a part of the Contract. All references in the Contract to Attachment I, Exhibit I, shall hereinafter also refer to Attachment I, Exhibit 1-A, as appropriate. |
| 2. | Attachment II, Core Contract Provisions, Section XVI., Terms and Conditions, is hereby amended to include Item GG. as follows: |
| | GG. Work Authorization Program |
| | The immigration Reform and Control Act of 1986 prohibits employers from knowingly hiring illegal workers. The Vendor shall only employ individuals who may legally work in the United States – either U.S. citizens or foreign citizens who are authorized to work in the U.S. The Vendor shall use the U.S. Department of Homeland Security’s E-Verify Employment Eligibility Verification system to verify the employment eligibility of: |
| | Ø | all persons employed by the Vendor, during the term of this Contract, to perform employment duties within Florida; and, |
| | Ø | all persons (including subcontractors) assigned by the Vendor to perform work pursuant to this Contract. |
| | The Vendor shall include this provision in all subcontracts it enters into for the performance of work under this Contract. |
| | |
| | Unless otherwise stated, this amendment is effective upon execution by both parties. |
| | |
| | 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. |
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AHCA Contract No. FA904, Amendment No. 6, Page 1 of 2
| WellCare of Florida, Inc. | | Medicaid HMO Non-Reform Contract |
| d/b/a Staywell Health Plan of Florida | | |
IN WITNESS WHEREOF, the Parties hereto have caused this five (5) page amendment (including all attachments) to be executed by their officials thereunto duly authorized.
WELLCARE OF FLORIDA, INC., D/B/A STAYWELL HEALTH PLAN OF FLORIDA | STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION |
| | | | | | |
| SIGNED | | | SIGNED | | |
| BY: | /s/Christina Cooper | | BY: | /s/ Elizabeth Dudek |
| NAME: | Christina Cooper | | Name: | Elizabeth Dudek |
TITLE: | President, Florida & Hawaii Division | | TITLE: | Secretary |
DATE: | 6/29/11 | | DATE: | 6/30/11 |
List of Attachments/Exhibits included as part of this amendment:
Specify Type | | Letter/ Number | | Description |
| Attachment I | | Exhibit 1-A | | Revised Maximum Enrollment Levels (3 Pages) |
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AHCA Contract No. FA904, Amendment No. 6, Page 2 of 2
| WellCare of Florida, Inc. | | Medicaid HMO Non-Reform Contract |
| d/b/a Staywell Health Plan of Florida | | |
ATTACHMENT I
EXHIBIT 1-A
REVISED MAXIMUM ENROLLMENT LEVELS
Maximum enrollment levels and Health Plan provider numbers associated with the counties and populations served. Exhibit 2-NR-B provide the capitation rate tables respective to the areas of operation listed below.
A. Non-Reform
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 3 Counties: Hernando, Sumter |
| | Effective Date: 09/01/09 |
| | County | Enrollment Level | Provider Number |
| | Hernando | 15,000 | 015016901 |
| | Sumter | 4,500 | 015016916 |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 5 Counties: Pasco, Pinellas |
| | Effective Date: 09/01/09 |
| | County | Enrollment Level | Provider Number |
| | Pasco | 7,000 | 015016903 |
| | Pinellas | 15,000 | 015016904 |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 6 Counties: Hillsborough, Manatee, Polk |
| | Effective Date: 09/01/09 |
| | County | Enrollment Level | Provider Number |
| | Hillsborough | 28,000 | 015016902 |
| | Manatee | 12,000 | 015016912 |
| | Polk | 25,000 | 015016905 |
AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 1 of 3
| WellCare of Florida, Inc. | | Medicaid HMO Non-Reform Contract |
| d/b/a Staywell Health Plan of Florida | | |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 7 Counties: Orange, Seminole, Osceola, Brevard |
| | Effective Date: 09/01/09 |
| | County | Enrollment Level | Provider Number |
| | Orange | 38,000 | 015016906 |
| | Seminole | 6,000 | 015016908 |
| | Osceola | 12,000 | 015016907 |
| | Brevard | 14,000 | 015016913 |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 8 Counties: Lee, Sarasota, Charlotte |
| | Effective Date: 09/01/09, and 08/01/11 Charlotte |
| | County | Enrollment Level | Provider Number |
| | Lee | 15,000 | 015016911 |
| | Sarasota | 6,000 | 015016914 |
| | Charlotte | 27,000 | TBD |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 9 Counties: Palm Beach, St. Lucie, Indian River |
| | Effective Date: 09/01/09, and 08/01/11 Indian River |
| | County | Enrollment Level | Provider Number |
| | Palm Beach | 15,000 | 015016910 |
| | St. Lucie | 4,500 | 015016915 |
| | Indian River | 10,500 | TBD |
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AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 2 of 3
| WellCare of Florida, Inc. | | Medicaid HMO Non-Reform Contract |
| d/b/a Staywell Health Plan of Florida | | |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 10 Counties: Broward |
| | Effective Date: 09/01/09 |
| | County | Enrollment Level | Provider Number |
| | Broward | 25,000 | 015016900 |
See Exhibit 2-NR-B Table 2, General Capitation Rates plus Mental Health Rates
| | Area 11 Counties: Miami-Dade |
| | Effective Date: 09/01/09 |
| | County | Enrollment Level | Provider Number |
| | Miami-Dade | 25,000 | 015016909 |
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AHCA Contract No. FA904, Attachment I, Exhibit 1-A, Page 3 of 3
