Delaware
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001-32209
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47-0937650
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(State or other jurisdiction
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(Commission File Number)
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(IRS Employer
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of incorporation)
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Identification No.)
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8735 Henderson Road, Renaissance One
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Tampa, Florida
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33634
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(Address of principal executive offices)
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(Zip Code)
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¨
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Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
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¨
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Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
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¨
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Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
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¨
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Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
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·
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Specifies the long-term care, acute care, case management and other services HealthEase is required to provide to members;
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·
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Sets the capitation rates payable by DOEA to HealthEase at $1,646.24 per member per month for the counties HealthEase will initially serve;
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Establishes certain performance standards for HealthEase relating to measures such as quality of care, access to care and financial solvency standards;
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Provides for the procedures for the enrollment and disenrollment of members into HealthEase’s plan;
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Requires HealthEase to maintain a quality assurance program, including the adoption a written description of the program, a procedure for delegation of quality assurance responsibilities and protocols for credentialing and re-credentialing and other quality issues;
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Requires HealthEase to maintain procedures related to grievances and appeals and sets forth certain requirements for such procedures;
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Provides for requirements relating to communications with members and potential members including required communications, such as the distribution of member handbooks and the provision of translation services; and
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Provides for reporting and record retention obligations for HealthEase.
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Date: July 13, 2012
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WELLCARE HEALTH PLANS, INC.
/s/ Lisa G. Iglesias
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Lisa G. Iglesias
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Senior Vice President, General Counsel & Secretary
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Exhibit No.
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Description
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