EX-10.2 4 exhibit3.htm EX-10.2 EX-10.2

AMERIGROUP FLORIDA, INC. Medicaid HMO Contract

AHCA CONTRACT NO. FA523
AMENDMENT NO. 8

THIS CONTRACT, entered into between the STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, hereinafter referred to as the “Agency” and AMERIGROUP 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 $680,379,083.00, (an increase of $10,560,000.00), 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
     8,000  
 
        
BROWARD
     14,000  
 
        
_DADE DADE
     25,000  
 
        
HILLSBOROUGH
     40,000  
 
        
LEE
     18,000  
 
        
MANATEE
     3,500  
 
        
ORANGE
     30,000  
 
        
OSCEOLA
     8,500  
 
        
PALM BEACH
     12,000  
 
        
PASCO
     15,000  
 
        
-PINELLAS
     25,000  
 
        
POLK
     30,000  
 
        
SARASOTA
     8,000  
 
        
SEMINOLELE
     8,000  
 
        

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

Table 3 Area

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

Table 3.
Areas 5, 6, 7, 8, 9, 10, and 11 Age-banded Capitation Rates, Including Community Mental Health and Mental Health Targeted Case Management Area 05 General Rates plus Mental Health Plan - 015005304(PASCO) 015005305(PINELLAS)

                                                                         
 
   <1 year     1-5       6-13             14-20 Male 14-20 Female 21-54 Male
   21-54Female     55-64       65+  
TANF/FC/SOBRA
     345.77       79.28       51.94       57.32       114,31       139.01       210.44       291.84       291,84  
SSI/NO Medicare
     3265.63       429.24       240.86       235.59       235.59       628.37       628.37       594.95       594.95  
SSI/Part B
     266.87       266.81       266.87       266.87       266.87       266.87       266.87       266.87       266.87  
SSI/Part A 6 B
     310.72       318.72       318.12       318.72       318.72       318.72       318,72       318.72       225,77  

Area 06 General Rates plus Mental Health Plan — 015005300(HILLSBOROUGH) 015005307(POLK) 015005318 (MANATEE)

                                                                         
    <1 year   -5   6-13           14-20 Male 14-20 Female 21-54 Male 21-54 Female           55-64   65+
TANF/FC/SOBRA   330.07   7591   61.92   61.67   122.23   135.83   204.29   282.98   282.98
SS1/No Medicare
     3017.05       37169       265.72       243.82       243,82       647.81       647.81       587,26       587.26  
SSI/Part B
     242.29       24229       242.29       242.29       242.29       242,29       242.29       242.29       242.29  
SSI/Part A 6 B
     288.09       288.09       288.09       288,09       288.09       288.09       288.09       288.09       202.64  

AHCA Contract No. FA523, Amendment No. 8, Page 1 of 3

AHCA Form 2100-0002 (Rev. NOV03)

1

AMERIGROUP FLORIDA, INC. Medicaid HMO Contract

Area 07 General Rates plus Mental Health Plan — 015005308 (ORANGE) 015005313(SEMINOLE) 015005314(OSCEOLA) 015005336(BREVARD)

                                                                         
 
   <1 year     1-:       6-13             14-20 Male 14-20 Female 21-54 Male
   21-54Female     55-64       65+  
TANF/FC/SOBRA
     337.20       76.9 )     58.07       59.10       114.69       136.45       206.32       287.87       287.87  
SSI/No Medicare
     3217.90       406,81       260.45       239.73       239.73       628.24       628.24       594.96       594.96  
SSI/Part B
     266.03       266.0       266.03       266.03       266.03       266.03       266.03       266.03       266.03  
SSI/Part A & B
     293.59       293.59       293.59       293.59       293.59       293.59       293.59       293.59       208.25  

Area 08 General Rates plus Mental Health Plan — 015005302 (LEE) 015005306(SARASOTA)

                                                                         
 
   <1 year     1-3       6-13             14-20 Male 14-20 Female 21-54 Male
   21-54Female     55-64       65+  
TANF/FC/SOBRA
     296.69       67.77     46,25     49.88       98.88       119,48       180.88       251.72       251.72  
SSI/No Medicare
     3079.31       393.43       223.95       221.50       221.50       594.93       594,93       563.76       563,76  
SSI/Part B
     243.57       243.51       243.57       243.57       243.57       243.57       243.57       243.57       243.57  
SSI/Part A 6 B
     292.10       292.30       292.10       292.10       292.10       292.10       292.10       292.10       206.49  

Area 09 General Rates plus Mental Health Plan — 015005310(PALM BEACH)

                                                                         
 
   <1 year     1-5       6-13             14-20 Male 14-20 Female 21-54 Male
   21-54Female     55-64       65+  
TANF/FC/SOBRA
     316.80       71.49       49.26       52.54       104,85       126.25       191.61       270.11       270.11  
SSI/No Medicare
     3344.06       424,:3       246.02       236.61       236.61       650.12       650,12       614.45       614,45  
SSI/Part B
     267.44       267.+4       267,44       267.44       267.44       267.44       267.44       267.44       267.44  
SSI/Part A & B
     331.80       331.10       331.80       331.80       331.00       331.80       331.80       331,80       235.67  

Area 10 General Rates plus Mental Health Plan — 015005311(BROWARD)

                                                                         
 
   <1 year     1.5     6-13           14-20 Male 14-20 Female 21-54 Male 21-54 Female
           55-64     65+  
TANF/FC/SOBRA
     328.75       75.74       60.81       58.42       112.75       132.87       201.05       203.53       283.53  
SSI/No Medicare
     4151.83       510.2       323.61       304.08       304.08       801.75       801.75       764.03       764.03  
SSI/Part B
     290.18       290..0       290.18       290,16       290.18       290.18       290.18       290.18       290.18  
SSI/Part A & B
     354.95       354.15       354.95       354.95       354.95       354.95       354,95       354.95       249.35  
                                                                         
Area 11 General Rates plus Mental ‘]Health Plan - 015005312(DADE)
                                                        
 
   <1 year     1.5       6-13             14-20 Male 14-20 Female 21-54 Male 21-54 Female
             55-64       65+  
TANF/FC/SOBRA
     409.17       92.16       69.70       69.26       136.84       161.91       246.27       343.39       343.39  
SSI/No Medicare
     4551.56       561.11       358.04       331.22       331.22       B76.41       876.41       832.73       832.73  
SSI/Part B
   451.58     451,58       451.58       451.58       451.58       451.58       451.50       451.58       451,58  
SSI/Part A & B
     420.30       420.10       420.30       420.30       420,30       420.30       420.30       420.30       295.40  

  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 $680,379,083.00, (an increase of $10,560,000.00), expressed on page seven of this contract.

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

All provisions in the Contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to con form 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 cam tot be executed unless all previous amendments to this Contract have been fully executed.

No. 8, Page 2 of 3

AHCA Form 2100-0002 (Rev. NOV03)

AMERIGROUP FLORIDA, INC. Medicaid HMO Contract

IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment (including all attachments) to be executed by their officials thereunto duly authorized.

AMERIGROUP FLORIDA, MC.

STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION

S.CONT

         
NAME: Don Gilmore
   NAME: Alan Levine
 
        
 
    
 
        
TITLE: CEO
      TITLE: Secretary
 
       
 
        
DATE:
  /s/ 6/21/05   DATE:, /S/
6/27/05
 
       

      THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY

AHCA Contract No. FA523, Amendment No. 8, Page 3 of 3

AHCA Form 2100-0002 (Rev. NOV03 )

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