Minor Modification No. 2 to AHCA Contract No. FA972 between WellCare of Florida, Inc. and the State of Florida Agency for Health Care Administration

Contract Categories: Business Finance › Modification Agreements
Summary

This document is a minor modification to an existing contract (No. FA972) between WellCare of Florida, Inc. (doing business as HealthEase) and the State of Florida's Agency for Health Care Administration. The modification updates the contact information for the Agency’s Contract Manager. All other terms and conditions of the original contract remain unchanged. The modification is signed and approved by representatives of both parties and is effective as of April 2014.

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EX-10.4 4 ex104fa972minor2.htm MINOR MODIFICATION NO. 2 TO CONTRACT FA972 Ex104FA972Minor2

Exhibit 10.4

AHCA CONTRACT NO. FA972

MINOR MODIFICATION NO. 2


WELLCARE OF FLORIDA, INC.
D/B/A HEALTHEASE
8735 Henderson Road
Renaissance 2
Tampa, Florida 33634

AHCA Contract No. FA972, as entered into on the 30th day of August 2012, is hereby revised as follows:

1.
Standard Contract, Section III, Item B., Contract Managers, sub-item 1, is hereby amended to now read as follows:

1.
The Agency’s Contract Manager’s contact information is as follows:

Tanya Hand
Agency for Health Care Administration
2727 Mahan Drive, MS #50
Tallahassee, FL 32308
(850) 412-4060

All other terms and conditions of the Contract shall remain unchanged.

WELLCARE OF FLORIDA, INC.
 
STATE OF FLORIDA, AGENCY FOR
D/B/A HEALTHEASE
 
HEALTH CARE ADMINISTRATION
 
 
 
 
 
 
 
 
 
/s/ Gregg MacDonald
 
/s/ Tanya Hand
Gregg MacDonald
 
Tanya Hand
State President
 
Contract Manager
 
 
 
 
 
DATE:
4-8-14
 
DATE:
4/9/14
 
 
 
 
 
 
 
 
APPROVED
 
 
 
 
 
 
 
 
 
 
 
 
 
/s/ David Rogers
 
 
 
David Rogers
 
 
 
Assistant Deputy Secretary for Medicaid
 
 
 
Health Systems
 
 
 
 
 
 
 
 
DATE:
4/9/14
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA Contract No. FA972, Minor Modification No. 2, Page 1 of 1