Medicare Advantage Attestation of Benefit Plan by WellCare Health Plans of New Jersey, Inc.
Summary
WellCare Health Plans of New Jersey, Inc. attests that its 2013 Medicare Advantage Plan Benefit Packages (PBPs) and related bid pricing tools have been reviewed and are accurate. The company commits to offering these benefits to eligible beneficiaries in the approved service area, in compliance with all applicable Medicare statutes, regulations, and guidance for 2013. The attestation is signed by a contracting official and confirms that the plan will adhere to all CMS requirements for the program year.
EX-10.5 6 h0913benefitattestation.htm H0913 BENEFIT ATTESTATION h0913benefitattestation.htm
Back to Form 8-K
Exhibit 10.5
Medicare Advantage Attestation of Benefit Plan
WELLCARE HEALTH PLANS OF NEW JERSEY, INC.
H0913
Date: 08/29/2012
I attest that I have examined the Plan Benefit Packages (PBPs) identified below and that the benefits identified in the PBPs are those that the above-stated organization will make available to eligible beneficiaries in the approved service area during program year 2013. I further attest that we have reviewed the bid pricing tools (BPTs) with the certifying actuary and have determined them to be consistent with the PBPs being attested to here.
I further attest that these benefits will be offered in accordance with all applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2012 and 2013, including but not limited to, the 2013 Call Letter, the 2013 Solicitations for New Contract Applicants, the Medicare Prescription Drug Benefit Manual, the Medicare Managed Care Manual, and the CMS memoranda issued through the Health Plan Management System (HPMS).
| Plan ID | Segment ID | Version | Plan Name | Plan Type | Transaction Type | MA Premium | Part D Premium | CMS Approval Date | Effective Date |
| 002 | 0 | 7 | WellCare Value (HMO) | HMO | Renewal | 0.00 | 0.00 | 08/20/2012 | 01/01/2013 |
| H0913 |
| THOMAS TRAN | 8/29/2012 1:38:10 PM | ||
| Contracting Official Name | Date | ||
| P.O. Box 26011 | |||
| WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | Tampa, FL ###-###-#### | ||
| Organization | Address |
H0913
