Amendment to Contract for Furnishing Health Services between the State of Illinois Department of Healthcare and Family Services and Harmony Health Plan of Illinois, Inc

EX-10.1 2 exhibit10-1.htm ILLINOIS AMENDMENT exhibit10-1.htm
Back to Form 8-K
Exhibit 10.1
 

ATTACHMENT I
RATE SHEETS
 
(a)
Contractor Name:
Harmony Health Plan of Illinois, Inc.
 
 
Address:
200 West Adams Street
Chicago, IL 60606
 
(b)
Contracting Arca(s) Covered by the Contractor and Enrollment Limit:

 
Contracting Area
Enrollment Limit
Region III - St. Clair, Madison, Perry,
Randolph, and Washington Counties
Jackson County (9/1/07)
Williamson County (9/1/07)
50,000
Region IV
200,000
   
 
(c)      Total Enrollment Limit for all Contracting Areas:    250,000

(e)       Standard Capitation Rates for Enrollees, effective August 1, 2006 through July 31, 2008:*


Age/Gender
Mo = month
Yr = year
Region I
(N-W, Illinois)
PMPM
Region II
(Central Illinois)
PMPM
Region III
(Southern Illinois)
PMPM
Region IV
(Cook County)
PMPM
Region V
(Collar Counties)
PMPM
0-3Mo
$1,290.99
$1 047.86
$1,214.79
$1,383.98
$1,008.88
4Mo-lYr
$122,07
$124.58
$147.56
$139.60
$131.27
2Yr-5Yr
$51.37
$55.46
$64.68
$59.00
$49.44
6Yr-13Yr
$43.52
$50.34
$55.12
$43.63
$40.03
14Yr-20Yr, Male
$75.31
$83.05
$78.87
$64.90
$82.39
14Yr-20Y, Female
$117.55
$118.15
$136.31
$100.33
$98.16
21Yr-44Yr,Male
$114.27
$136.04
$123.73
$127.39
$166.05
2 lYr-44Yr, Female
$157.98
$157.44
$166.17
$149.48
$151.36
45Yrf Male and Female
$227.11
$255.07
$256.05
$239.45
$253.90
 
* Capitation rates listed are 100% of actuarially certified rates, but only 99.5% will be paid in year one of the Contract and 99% in year two of the Contract in accordance with Section 7.8.

(f)       Hospital Delivery Case Rate, effective August 1, 2006 through July 31, 2008:

 
Hospital Delivery Case Rate (per delivery)
$3,501.90
$3,424.73
$3,591.08
$3,977.36
$3,645.96