Current Assets
EX-10.8 9 g19033exv10w8.htm EX-10.8 EX-10.8
Exhibit 10.8
Medicare Advantage Attestation of Benefit Plan
WELLCARE_OF NEW YORK, INC.
H3361
Date: 09/02/2008
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 2009. 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 attest that I have examined the employer/union-only group waiver (“800 series”) PBPs identified below and that these PBPs are those that the above-stated organization will make available only to eligible employer/union-sponsored group plan beneficiaries in the approved service area during program year 2009. I further attest we have reviewed any MA bid pricing tools (BPTs) associated with these PBPs (no Part D bids are required for 2009 “800 series” PBPs) with the certifying actuary and have determined them to be consistent with any MA PBPs being attested to here.
I further attest that these benefits will be offered in accordance with ail applicable Medicare program authorizing statutes and regulations and program guidance that CMS has issued to date and will issue during the remainder of 2008 and 2009, including but not limited to, the 2009 Call Letter, the 2009 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 | Segment | Plan | Transaction | MA | Part D | CMS Approval | Effective | |||||||||||
| ID | ID | Version | Plan Name | Type | Type | Premium | Premium | Date | Date | |||||||||
| 020 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 021 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 024 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 027 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 031 | 0 | 7 | WellCare Access | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 039 | 0 | 5 | WellCare Dividend | HMO | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||
| 043 | 0 | 7 | WellCare Select | HMOPOS | Renewal | 0.00 | 25.90 | 08/29/2008 | 01/01/2009 | |||||||||
| 047 | 0 | 7 | WellCare Liberty | HMO | Renewal | 35.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 050 | 0 | 7 | WellCare Liberty | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 051. | 0 | 6 | WellCare Passport | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 056 | 0 | 5 | WellCare Advance | HMO | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||
| 059 | 0 | 5 | WellCare Advance | HMO | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||
| 065 | 0 | 6 | WellCare Access | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 |
Page 1 of 4 — WELLCARE_OF NEW YORK, INC. — H3361 — 09/02/2008
| Plan | Segment | Plan | Transaction | MA | Part D | CMS Approval | Effective | |||||||||||
| ID | ID | Version | Plan Name | Type | Type | Premium | Premium | Date | Date | |||||||||
| 077 | 0 | 5 | WellCare Advance | HMO | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||
| 084 | 0 | 6 | WellCare Select | HMOPOS | Renewal | 0.00 | 17.80 | 08/29/2008 | 01/01/2009 | |||||||||
| 098 | 0 | 6 | WellCare Select | HMOPOS | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 099 | 0 | 6 | WellCare Value | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 101 | 0 | 5 | WellCare Advance | HMO | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||
| 102 | 0 | 6 | WellCare Value | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 104 | 0 | 6 | WellCare Value | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 105 | 0 | 7 | WellCare Advocate Complete | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 106 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 107 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 109 | 0 | 8 | WellCare Access | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 110 | 0 | 8 | WellCare Access | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 111 | 0 | 9 | WellCare Access | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 112 | 0 | 6 | WellCare Choice | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 113 | 0 | 6 | WellCare Value | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 115 | 0 | 6 | WellCare Value | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 116 | 0 | 6 | WellCare Access | HMO | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 117 | 0 | 6 | WellCare Select | HMOPOS | Renewal | 0.00 | 27.70 | 08/29/2008 | 01/01/2009 | |||||||||
| 119 | 0 | 5 | WellCare Advance | HMO | Renewal | 0.00 | N/A | 08/29/2008 | 01/01/2009 | |||||||||
| 120 | 0 | 5 | WellCare Dividend Plus | HMO | Renewal | 0.00 | N/A | 08/29/2008 | 01/01/2009 | |||||||||
| 124 | 0 | 5 | WellCare Dividend | HMO | Renewal | 0.00 | N/A | 08/29/2008 | 01/01/2009 | |||||||||
| 125 | 0 | 7 | WellCare Olympic | HMOPOS | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 | |||||||||
| 801 | 0 | 3 | WellCare Employer NY1 | HMOPOS | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||
| 802 | 0 | 3 | WellCare Employer NY2 | HMOPOS | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 |
Page 2 of 4 — WELLCARE_OF NEW YORK, INC. — H3361 — 09/02/2008
| Plan | Segment | Plan | Transaction | MA | Part D | CMS Approval | Effective | |||||||||||||||||||
| ID | ID | Version | Plan Name | Type | Type | Premium | Premium | Date | Date | |||||||||||||||||
| 803 | 0 | 3 | WellCare Employer NY 3 | HMOPOS | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||||||||||
| 804 | 0 | 3 | WellCare Employer NY 4 | HMOPOS | Renewal | 0.00 | N/A | 09/02/2008 | 01/01/2009 | |||||||||||||||||
Page 3 of 4 — WELLCARE_OF NEW YORK, INC. — H3361 — 09/02/2008
/s/ Heath Schiesser | 9/5/08 | |||
CEO: | Date: | |||
Heath Schiesser CEO/President 8735 Henderson Road Tampa, FL 33634 813 ###-###-#### | ||||
/s/ Thomas L. Tran | 9/5/08 | |||
CFO: | Date: | |||
Tom Tran CFO 8735 Henderson Road Tampa, FL 33634 813 ###-###-#### (1770) |
Page 4 of 4 — WELLCARE_OF NEW YORK, INC. — H3361 — 09/02/2008
