Renewal Notice regarding Contract S5967 between the Centers for Medicare and Medicaid Services and WellCare Prescription Insurance, Inc. and related benefit attestation
EX-10.1 2 cmsrenewalltr.htm CMS RENEWAL LETTER AND BENEFIT ATTESTATION cmsrenewalltr.htm Back to Form 8-K
September 10, 2009 CONTRACT Id: S5967
Exhibit 10.1
[CMS LOGO]
DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland ###-###-####
CENTER FOR DRUG AND HEALTH PLAN CHOICE |
September 10, 2009 CONTRACT Id: S5967
Heath Schiesser
8735 Henderson Road
Tampa, FL 33634
RE: 2010 Contract Renewal for Contract S5967
Dear Heath Schiesser,
The Centers for Medicare and Medicaid Services (CMS) is pleased to inform you that we are renewing your organization’s Medicare Prescription Drug Plan (PDP) Sponsor contract effective January 1, 2010 through December 31, 2010. This renewal is issued based on our approval of your bids and receipt of your signed 2010 Benefit Attestation, This contract renewal includes any applicable addendum that governs the operation of Employer/Union-Only Group Waiver (“800 Series”) Plans.
CMS will continue to provide Prescription Drug Benefit program information to contracting organizations through the Health Plan Management System (HPMS) and the CMS Web site. It is imperative that you monitor both of these resources to stay current on program requirements and information. We further remind you to ensure that your organization’s contact information in HPMS remains accurate, as that is our primary mechanism for contacting contracted organizations.
We look forward to continuing to work with you in serving Medicare beneficiaries in your service area. If you have any questions, please contact your Account Manager.
Sincerely,
/s/ Cynthia G. Tudor
Cynthia G. Tudor, Ph.D.
Director
Medicare Drug Benefit and C & D Data Group
Prescription Drug Plan Attestation of Benefit Plan
WELLCARE PRESCRIPTION INSURANCE, INC.
S5967
Date: 08/31/2009
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 2010. 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 2009 and 2010, including but not limited to, the 2010 Call Letter, the 2010 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 | Part D Premium | CMS Approval Date | Effective Date |
035 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 32.50 | 8/28/2009 | 1/1/2010 |
036 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 39.60 | 8/28/2009 | 1/1/2010 |
037 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 41.60 | 8/28/2009 | 1/1/2010 |
038 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 41.10 | 8/28/2009 | 1/1/2010 |
039 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 40.30 | 8/28/2009 | 1/1/2010 |
040 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 38.30 | 8/28/2009 | 1/1/2010 |
041 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 41.30 | 8/28/2009 | 1/1/2010 |
042 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 41.30 | 8/28/2009 | 1/1/2010 |
043 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 42.70 | 8/28/2009 | 1/1/2010 |
044 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 39.30 | 8/28/2009 | 1/1/2010 |
Page 1 of 6 - WELLCARE PRESCRIPTION INSURANCE, INC. – S5967 – 08/31/2009
Plan ID | Segment ID | Version | Plan Name | Plan Type | Transaction Type | Part D Premium | CMS Approval Date | Effective Date |
045 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 30.80 | 8/28/2009 | 1/1/2010 |
046 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 44.00 | 8/28/2009 | 1/1/2010 |
047 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 39.40 | 8/28/2009 | 1/1/2010 |
048 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 37.00 | 8/28/2009 | 1/1/2010 |
049 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 42.50 | 8/28/2009 | 1/1/2010 |
051 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 39.40 | 8/28/2009 | 1/1/2010 |
052 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 39.60 | 8/28/2009 | 1/1/2010 |
053 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 41.30 | 8/28/2009 | 1/1/2010 |
054 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 43.50 | 8/28/2009 | 1/1/2010 |
055 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 40.10 | 8/28/2009 | 1/1/2010 |
056 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 37.10 | 8/28/2009 | 1/1/2010 |
057 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 42.50 | 8/28/2009 | 1/1/2010 |
058 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 40.00 | 8/28/2009 | 1/1/2010 |
059 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 49.70 | 8/28/2009 | 1/1/2010 |
060 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 31.20 | 8/28/2009 | 1/1/2010 |
061 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 40.90 | 8/28/2009 | 1/1/2010 |
062 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 35.00 | 8/28/2009 | 1/1/2010 |
063 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 36.30 | 8/28/2009 | 1/1/2010 |
Page 2 of 6 - WELLCARE PRESCRIPTION INSURANCE, INC. – S5967 – 08/31/2009
Plan ID | Segment ID | Version | Plan Name | Plan Type | Transaction Type | Part D Premium | CMS Approval Date | Effective Date |
064 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 45.50 | 8/28/2009 | 1/1/2010 |
065 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 51.50 | 8/28/2009 | 1/1/2010 |
066 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 33.10 | 8/28/2009 | 1/1/2010 |
067 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 30.00 | 8/28/2009 | 1/1/2010 |
068 | 0 | 2 | WellCare Signature (PDP) | Medicare Prescription Drug Plan | Renewal | 34.50 | 8/28/2009 | 1/1/2010 |
138 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 26.90 | 8/28/2009 | 1/1/2010 |
139 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 30.80 | 8/28/2009 | 1/1/2010 |
140 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 33.30 | 8/28/2009 | 1/1/2010 |
141 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 39.80 | 8/28/2009 | 1/1/2010 |
142 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 30.50 | 8/28/2009 | 1/1/2010 |
143 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 37.30 | 8/28/2009 | 1/1/2010 |
144 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 33.20 | 8/28/2009 | 1/1/2010 |
145 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 36.30 | 8/28/2009 | 1/1/2010 |
146 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 30.80 | 8/28/2009 | 1/1/2010 |
147 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 27.40 | 8/28/2009 | 1/1/2010 |
148 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 28.80 | 8/28/2009 | 1/1/2010 |
149 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 33.70 | 8/28/2009 | 1/1/2010 |
150 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 30.30 | 8/28/2009 | 1/1/2010 |
Page 3 of 6 - WELLCARE PRESCRIPTION INSURANCE, INC. – S5967 – 08/31/2009
Plan ID | Segment ID | Version | Plan Name | Plan Type | Transaction Type | Part D Premium | CMS Approval Date | Effective Date |
151 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 38.00 | 8/28/2009 | 1/1/2010 |
152 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 36.90 | 8/28/2009 | 1/1/2010 |
154 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 34.90 | 8/28/2009 | 1/1/2010 |
155 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 31.10 | 8/28/2009 | 1/1/2010 |
156 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 23.20 | 8/28/2009 | 1/1/2010 |
157 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 31.40 | 8/28/2009 | 1/1/2010 |
158 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 26.90 | 8/28/2009 | 1/1/2010 |
159 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 24.50 | 8/28/2009 | 1/1/2010 |
160 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 29.80 | 8/28/2009 | 1/1/2010 |
161 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 37.90 | 8/28/2009 | 1/1/2010 |
162 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 40.90 | 8/28/2009 | 1/1/2010 |
163 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 18.00 | 8/28/2009 | 1/1/2010 |
164 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 29.10 | 8/28/2009 | 1/1/2010 |
165 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 19.70 | 8/28/2009 | 1/1/2010 |
166 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 28.70 | 8/28/2009 | 1/1/2010 |
167 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 39.20 | 8/28/2009 | 1/1/2010 |
168 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 44.50 | 8/28/2009 | 1/1/2010 |
169 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 24.30 | 8/28/2009 | 1/1/2010 |
Page 4 of 6 - WELLCARE PRESCRIPTION INSURANCE, INC. – S5967 – 08/31/2009
Plan ID | Segment ID | Version | Plan Name | Plan Type | Transaction Type | Part D Premium | CMS Approval Date | Effective Date |
170 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 38.70 | 8/28/2009 | 1/1/2010 |
171 | 0 | 2 | WellCare Classic (PDP) | Medicare Prescription Drug Plan | Renewal | 33.30 | 8/28/2009 | 1/1/2010 |
Page 5 of 6 - WELLCARE PRESCRIPTION INSURANCE, INC. – S5967 – 08/31/2009
/s/ Heath Schiesser | 9/4/09 | ||
CEO: | Date | ||
Heath Schiesser CEO/President 8735 Henderson Road Tampa, FL 33634 813 ###-###-#### |
/s/ Thomas L. Tran | 9/4/09 | ||
CFO: | Date | ||
Thomas L. Tran CFO 8735 Henderson Road Tampa, FL 33634 813 ###-###-#### (1770) |
PDP benefit attestations should be sent by overnight courier to:
Centers for Medicare & Medicaid Services
ATTN: Julie Gover/Part D Benefit Attestation
Mail Stop C1-26-12
7500 Security Boulevard
Baltimore, MD ###-###-####
Page 6 of 6 - WELLCARE PRESCRIPTION INSURANCE, INC. – S5967 – 08/31/2009