Medicare Advantage Attestation of Benefit Plan by WellCare Health Insurance of Illinois, Inc. (2009)
Summary
WellCare Health Insurance of Illinois, Inc. attests that its Medicare Advantage Plan Benefit Packages for 2009 have been reviewed and will be offered to eligible beneficiaries in the approved service area. The company confirms that the benefits and pricing are consistent and comply with all applicable Medicare regulations and guidance. The attestation is signed by the CEO and CFO, confirming their commitment to provide the stated benefits for the 2009 program year.
EX-10.11 12 g19033exv10w11.htm EX-10.11 EX-10.11
Exhibit 10.11
Medicare Advantage Attestation of Benefit Plan
WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.
H0967
Date: 08/29/2008
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 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 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).
| CMS | ||||||||||||||||||
| Plan | Segment | Plan | Transaction | MA | Part D | Approval | Effective | |||||||||||
| ID | ID | Version | Plan Name | Type | Type | Premium | Premium | Date | Date | |||||||||
| 001 | 0 | 8 | WellCare PPO | Local PPO | Renewal | 0.00 | 0.00 | 08/29/2008 | 01/01/2009 |
Page 1 of 2 — WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. — H0967 — 08/29/2008
/s/ Heath Schiesser | 9/5/08 Date: | |||
Heath Schiesser CEO/President 8735 Henderson Road Tampa, FL 33634 813 ###-###-#### | ||||
/s/ Thomas L. Tran | 9/5/08 Date: | |||
Tom Tran CFO 8735 Henderson Road Tampa, FL 33634 813 ###-###-#### (1770) |
Page 2 of 2 — WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. — H0967 — 08/29/2008
