Back to Form 8-K
Exhibit 10.1
[CMS
LOGO]
DEPARTMENT OF
HEALTH & HUMAN SERVICES
Centers for
Medicare & Medicaid Services
7500 Security
Boulevard
Baltimore,
Maryland 21244-1850
|
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
|
8/28/200
|