plan directory for medicare advantage, cost, pace, and ... · contract number: 90091 legal entity...

Plan Directoryfor

Medicare Advantage, Cost, PACE, and Demonstration

Organizations

Sorted by Contract Number

CPC/MDBG/DPDJune 2009

IMPORTANT NOTES

1. This directory contains information for Medicare Advantage, demonstration, PACE, and cost organizations that have an active contract with CMS at the time of the directory’s publication.

2. These data have been extracted from the Health Plan Management System (HPMS), maintained by the Center for Drug and Health Plan Choice/Medicare Drug Benefit and C & D Data Group/Division of Plan Data (CPC/MDBG/DPD).

3. This directory will be updated on a monthly basis.

4. The plan directory contact data is maintained by each organization in HPMS. If an organization needs to update its contact data, the plan user should use the following navigation path in HPMS: HPMS Homepage > Contract Management > Contract Management > Select a Contract Number > Contact Data > Plan Directory Contact for Public Website.

5. The enrollment number displayed in this directory has been pulled from the “Monthly Enrollment by Contract” file posted on the CMS public website at: http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/02_EnrollmentData.asp

6. This enrollment number represents the number of enrollees for which the contract received payment for the month.

7. As asterisk in place of the enrollment number indicates that the count is less than 10.

8. Pilot contracts are excluded from this directory.

Contract Number: 90091 Legal Entity Name: UNITED MINE WORKERS OF AMERICA HEALTH & RETIREMENT

Organization Marketing Name: United Mine Workers of America Health & Retirement Parent Organization: UNITED MINE WORKERS OF AMERICA

HCPP - 1833 Cost Organization Type: Contact Title: HCPP - 1833 Cost Plan Type: Name: Health Call Center 2/1/1974 Contract Effective Date: 1-800-291-1425 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-304-256-2626 Fax:

Enrollment: 36,131 [email protected] Email: P.O. Box 2320 Address:

2121 K STREET, N.W. Legal Entity Address: SUITE 350 BeckleyCity: WASHINGTON City: WVState: DCState: 25802Zip: 20037 Zip: 4/24/2009Last Updated:

Contract Number: E5088 Legal Entity Name: DESERET HEALTHCARE EMPLOYEE BENEFITS TRUST

Organization Marketing Name: Deseret Mutual Parent Organization: DMBA (Deseret Mutual Benefit Administrators)

Employer/Union Only Direct Contract PFFS Organization Type: Contact Title: Employer/Union Only Direct Contract PFFS Plan Type: Name: Customer Service 1/1/2007 Contract Effective Date: 1-877-220-0110 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: 1-843-736-0036 Fax:

Enrollment: 11,513 [email protected] Email: 60 East South Temple Address:

60 E. South Temple Legal Entity Address: Salt Lake CityCity:

Salt Lake CityCity: UTState: UTState: 84111Zip: 84111 Zip: 4/12/2007Last Updated:

Contract Number: E6036 Legal Entity Name: ASOCIACION DE MAESTROS DE PUERTO RICO

Organization Marketing Name: PROSSAM Plus Parent Organization: Asociacion De Maestros De Puerto Rico

Organization Type: Employer/Union Only Direct Contract PFFS Contact Title: Plan Type: Employer/Union Only Direct Contract PFFS Name: Susana Garcia

Contract Effective Date: 1/1/2008 Phone: 1-787-767-2020 Tax Status: Not-for-Profit/Non-Profit Extension: 1391

CMS Region Responsible: New York Fax: 1-787-763-2726 Enrollment: 2,025 Email: [email protected]

Address: 452 Ponce de Le≤n Ave. Legal Entity Address: 452 Ponce de Leon Ave

City: San Juan City: San Juan State: PR

State: PR Zip: 00919 Zip: 00917 Last Updated: 6/25/2008

Contract Number: H0046 Legal Entity Name: PROSALUD HMO CORPORATION

Organization Marketing Name: ProSalud Medicare Esencial Activo Parent Organization: Jaahel Group, Inc.

Organization Type: Local CCP Contact Title: System Information Manager Plan Type: Local PPO Name: Emmanuel Morales

Contract Effective Date: 1/1/2009 Phone: 1-787-200-1101 Tax Status: For Profit Extension:

CMS Region Responsible: New York Fax: Enrollment: 296 Email: [email protected]

Address: Suite 232, 85 De Diego Avenue Legal Entity Address: Villas de San Francisco III, Ave. De Diego #85

Suite 232 City: San Juan City: San Juan State: PR


June 2009 Contract Directory Sorted by Contract Number of 190

Contract Number: H0084 Legal Entity Name: CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY

Organization Marketing Name: Care Improvement PPO Parent Organization: XLHealth Corporation

Local CCP Organization Type: Marketing Manager Contact Title: Local PPO Plan Type: Name: Misty Smith 1/1/2009 Contract Effective Date: 1-410-625-2200 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: * [email protected] Email: 351 West Camden Street Address:

351 West Camden Street Legal Entity Address: Suite 100 Suite 100 Baltimore City: Baltimore City: MDState: MDState: 21201Zip: 212012473 Zip: 4/16/2009Last Updated:

Contract Number: H0087 Legal Entity Name: HEALTH ALLIANCE MEDICAL PLANS

Organization Marketing Name: Health Alliance Medical Plans Parent Organization: Health Alliance Medical Plans

PFFS Organization Type: Medicare Services Manager Contact Title: PFFS Plan Type: Name: Jennifer Marquardt 1/1/2008 Contract Effective Date: 1-217-337-8439 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-217-337-3425 Fax:

Enrollment: 20 [email protected] Email: 301 S. Vine St. Address:

301 S. Vine St.Legal Entity Address: Urbana City:

Urbana City: ILState: ILState: 61801Zip: 61801 Zip: 2/29/2008Last Updated:

Contract Number: H0097 Legal Entity Name: QCC INSURANCE COMPANY

Organization Marketing Name: Select Advantage Parent Organization: Independence Blue Cross

PFFS Organization Type: Contact Title: PFFS Plan Type: Name: Plan Inquiries 1/1/2008 Contract Effective Date: 1-800-331-0017 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 178 [email protected]: 1901 Market St Address:

1901 Market Street Legal Entity Address: PhiladelphiaCity:

Philadelphia City: PAState: PAState: 19103Zip: 19103 Zip: 9/5/2007Last Updated:

Contract Number: H0104 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF ALABAMA

Organization Marketing Name: Blue Cross Blue Shield of Alabama Parent Organization: BlueCross BlueShield of Alabama

Organization Type: Local CCP Contact Title: Senior Products Operations Manager Plan Type: Local PPO Name: Sharon R Smith

Contract Effective Date: 7/1/2005 Phone: 1-800-517-6425 Tax Status: Not-for-Profit/Non-Profit Extension:

CMS Region Responsible: Atlanta Fax: Enrollment: 65,837 Email: [email protected]

Address: 450 Riverchase Parkway East Legal Entity Address: 450 RIVERCHASE PARKWAY EAST Mail Stop F03020

City: Birmingham City: BIRMINGHAM State: AL

State: AL Zip: 35244 Zip: 35244 Last Updated: 5/18/2009


THE METHODIST OAKS H0105

Legal Entity Name: Contract Number:

Organization Marketing Name: The Methodist Oaks d.b.a. The Oaks PACE The Methodist Oaks Parent Organization: National PACE National PACE 3/1/2008

153 Founders Court

Orangeburg SC 29118

Not-for-Profit/Non-Profit Atlanta

Organization Type: Plan Type:

Contract Effective Date:

City: State:

Zip:

Tax Status: CMS Region Responsible:

Enrollment: 31

Legal Entity Address:

Data/Billing Specialist

1-803-534-1212 1113 1-803-535-1540 [email protected] P.O.Drawer 327

Orangeburg SC 29116 9/24/2008

Contact Title:

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Debbie Robinson Name:

WELLCARE OF OHIO, INC. H0117


Organization Marketing Name: WellCare WellCare Health Plans, Inc. Parent Organization: Local CCP HMO/HMOPOS 1/1/2008

8735 Henderson Rd Ren 1 Tampa FL 33634

For Profit Atlanta



City: State:

Zip:


Enrollment: 2,487


Plan Directory Contact

1-888-888-9355 3091

[email protected] 8735 Henderson Road

Tampa FL 33634 5/19/2009

Contact Title:

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Address:

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Name: Mary Solomon

CARESOURCE MICHIGAN H0141


Organization Marketing Name: CareSource CareSourceParent Organization: Local CCP HMO/HMOPOS 1/1/2008

2369 Woodlake Drive, Suite 200

Okemos MI 48864

Not-for-Profit/Non-Profit Chicago



City: State:

Zip:


Enrollment: 85


Director of Communications

1-937-224-3300 2910 1-937-425-0864 [email protected] P. O. Box 8738

Dayton OH 45401 3/6/2009

Contact Title:

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Name: Michelle Chapman

HEALTHSPRING OF ALABAMA, INC. H0150


Healthspring of Alabama, Inc. Organization Marketing Name: HealthSpring, Inc. Parent Organization: Local CCP HMO/HMOPOS 3/1/1994

Two Chase Corporate Drive Ste 300 BIRMINGHAM AL 35244

For Profit Denver



City: State:

Zip:


Enrollment: 30,013


Vice President of Customer Service

1-832-553-3300 3379

[email protected] 2900 North Loop West Suite 1300 Houston TX 77092 12/18/2008

Contact Title:

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Name: Wendy Wetzel


Contract Number: H0151 Legal Entity Name: UNITEDHEALTHCARE OF ALABAMA, INC.

Organization Marketing Name: SecureHorizons by UnitedHealthcare Parent Organization: UnitedHealth Group, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Richard IrwinName: 2/1/1995 Contract Effective Date: 1-888-867-5517 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:

Enrollment: 32,915 [email protected] Email: 5757 Plaza Dr Address:

13621 NW 12TH ST Legal Entity Address: CA124-0142 CyressCity:

SUNRISE City: CAState: FLState: 90630Zip: 33323 Zip: 4/14/2009Last Updated:

Contract Number: H0154 Legal Entity Name: VIVA HEALTH, INC.

Organization Marketing Name: VIVA Medicare Plus Parent Organization: UAB Health System

Organization Type: Local CCP Contact Title: VIVA Medicare Plus Member Services Plan Type: HMO/HMOPOS Name: Member Services


CMS Region Responsible: Atlanta Fax: 1-205-558-7414 Enrollment: 28,050 Email: [email protected]

Address: 1222 14th Avenue South Legal Entity Address: 1222 14th Avenue South

City: Birmingham City: BIRMINGHAM State: AL

State: AL Zip: 35205 Zip: 35205 Last Updated: 12/12/2007

Contract Number: H0245 Legal Entity Name: UNISON HEALTH PLAN OF TENNESSEE, INC.

Organization Marketing Name: Unison Advantage Parent Organization: UnitedHealth Group, Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Member Services Dept


CMS Region Responsible: Philadelphia Fax: Enrollment: 41 Email: [email protected]

Address: Unison Plaza Legal Entity Address: 890 Willow Tree Circle 1001 Brinton Road

Suite 10 City: Pittsburgh City: Cordova State: PA

State: TN Zip: 15221 Zip: 38018 Last Updated: 4/23/2007

Contract Number: H0248 Legal Entity Name: HUMANA INSURANCE COMPANY

Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc.

Organization Type: Local CCP Contact Title: Plan Type: Local PPO Name: Customer Service


CMS Region Responsible: Kansas City Fax: Enrollment: 1,848 Email: [email protected]

Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard

City: Louisville City: DePere State: KY

State: WI Zip: 40202 Zip: 54115 Last Updated: 1/31/2008


Contract Number: H0251 Legal Entity Name: UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.

Organization Marketing Name: AmeriChoice Secure Plus Complete Parent Organization: UnitedHealth Group, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2007 Contract Effective Date: 1-800-690-1606 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 8,481 [email protected] Email: 3800 River Drive, Suite 200 Address:

1300 River Drive, Suite 200 Legal Entity Address: MolineCity:

MolineCity: ILState: ILState: 61265Zip: 61265 Zip: 5/22/2007Last Updated:

Contract Number: H0302 Legal Entity Name: BANNER MEDISUN, INC.

Organization Marketing Name: MediSunONE Parent Organization: Banner Health

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 8/1/1999 Contract Effective Date: 1-800-446-8331 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-623-974-7439 Fax:


P.O. Box 1489 Legal Entity Address: 13632 N. 99th Ave. Suite B 13632 North 99th Ave, Suite B Sun CityCity: Sun City City: AZState: AZState: 85372Zip: 85372 Zip: 9/15/2008Last Updated:

Contract Number: H0303 Legal Entity Name: PACIFICARE OF ARIZONA, INC


Local CCP HMO/HMOPOS 4/1/1986

410 NORTH 44TH STREET PO BOX 52078 PHOENIX AZ 850722078

For Profit San Francisco



City: State:

Zip:


Enrollment: 94,599


HUMANA HEALTH PLAN, INC. H0307


Humana Health Plan, Inc. Organization Marketing Name: Humana Inc.Parent Organization: Local CCP HMO/HMOPOS 4/1/1988

201 West Main Street

Louisville KY 40202

For Profit Kansas City



City: State:

Zip:


Enrollment: 11,268


1-888-867-5517

1-714-226-6811 [email protected] 5757 Plaza Dr CA124-0142 Cyress CA 90630 4/14/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

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Richard IrwinName:

1-800-457-4708

[email protected] 101 East Main Street

Louisville KY 40202 8/22/2006

Contact Title:

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Address:

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Name: Customer Service


Contract Number: H0316 Legal Entity Name: UNITEDHEALTHCARE OF ARIZONA, INC.




9900 BREN ROAD EAST Legal Entity Address: CA124-0142 MAIL ROUTE MN008-W140 CyressCity: MINNETONKA City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:



Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Customer Service 1/1/2005 Contract Effective Date: 1-800-457-4708 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:

Enrollment: 8,498 [email protected]: 101 East Main Street Address:

1100 Employers Boulevard Legal Entity Address: LouisvilleCity:

DePere City: KYState: WIState: 40202Zip: 54115 Zip: 8/22/2006Last Updated:

Contract Number: H0318 Legal Entity Name: AETNA HEALTH INC.

Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Aetna Customer Service


CMS Region Responsible: Boston Fax: Enrollment: 1,274 Email: [email protected]

Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue

Mail Stop RT 11 City: Hartford City: Hartford State: CT

State: CT Zip: 06156 Zip: 06156 Last Updated: 8/22/2006

Contract Number: H0319 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY

Organization Marketing Name: Evercare« Health Plans Parent Organization: UnitedHealth Group, Inc.

Organization Type: Local CCP Contact Title: Plan Type: Local PPO Name: Richard Irwin


CMS Region Responsible: San Francisco Fax: 1-714-226-6811 Enrollment: 7,417 Email: [email protected]

Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA124-0142

MN008-W130 City: Cyress City: MINNETONKA State: CA

State: MN Zip: 90630 Zip: 55343 Last Updated: 4/14/2009


Contract Number: H0320

Legal Entity Name: ARCADIAN HEALTH PLAN, INC.Organization Marketing Name: Desert Canyon Community Care

Parent Organization: Arcadian Management Services Inc.Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Service 7/1/2005 Contract Effective Date: 1-800-573-8597 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 3,016 [email protected] Email: 825 Washington St. Suite 300 Address:

825 WASHINGTON STREET Suite 300 Legal Entity Address: OaklandCity:

OAKLAND City: CAState: CAState: 94607Zip: 94607 Zip: 2/28/2008Last Updated:

Contract Number: H0321 Legal Entity Name: ARIZONA PHYSICIANS IPA, INC.

Organization Marketing Name: APIPA Personal Care Plus Parent Organization: UnitedHealth Group, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 9/1/2005 Contract Effective Date: 1-877-614-0623 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 15,334 [email protected] Email: 3141 North 3rd Ave Address:

3141 North Third Avenue Legal Entity Address: PhoenixCity:

Phoenix City: AZState: AZState: 85013Zip: 85013 Zip: 12/18/2008Last Updated:

Contract Number: H0322 Legal Entity Name: AETNA LIFE INSURANCE COMPANY


Organization Type: Local CCP Contact Title: Plan Type: Local PPO Name: Aetna Customer Service


CMS Region Responsible: Boston Fax: Enrollment: 379 Email: [email protected]

Address: 151 Farmington Avenue Legal Entity Address: 151 FARMINGTON AVE

City: Hartford City: HARTFORD State: CT


Contract Number: H0332 Legal Entity Name: KS PLAN ADMINISTRATORS, LLC

Organization Marketing Name: KelseyCare Advantage Parent Organization: KS Plan Administrators, LLC

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Member Services


CMS Region Responsible: Dallas Fax: 1-713-442-9541 Enrollment: 9,740 Email: [email protected]

Address: 8900 Lakes at 610 Dr. Suite 1100 Legal Entity Address: 2727 West Holcombe

4th Floor, Admin City: Houston City: Houston State: TX

State: TX Zip: 77054 Zip: 77025 Last Updated: 1/14/2008



Legal Entity Name: PACE VERMONT, INC.Organization Marketing Name: PACE Vermont, Inc

Parent Organization: PACE VERMONT, INC.Organization Type: National PACE Contact Title: Administrative & Fiscal Service Manager

Plan Type: National PACE Name: Patricia Gratton Contract Effective Date: 3/1/2007 Phone: 1-802-655-6700

Tax Status: Not-for-Profit/Non-Profit Extension: 104 CMS Region Responsible: Boston Fax: 1-802-655-6760

Enrollment: 57 Email: [email protected] Address: 786 College Parkwary

Legal Entity Address: 786 College Parkway City: Colchester

City: Colchester State: VT State: VT Zip: 05446

Zip: 05446 Last Updated: 5/29/2007 Contract Number: H0351 Legal Entity Name: HEALTH NET OF ARIZONA, INC.

Organization Marketing Name: Health Net of Arizona, Inc. Parent Organization: Health Net, Inc.

Organization Type: Local CCP Contact Title: Provider and Provider Directory Information Plan Type: HMO/HMOPOS Name: Member Services


CMS Region Responsible: Seattle Fax: Enrollment: 60,483 Email: [email protected]

Address: 1230 W. Washington St., Ste. 401 Legal Entity Address: 1230 W. Washington St.

Suite 401 City: Tempe City: Tempe State: AZ

State: AZ Zip: 85281-2145 Zip: 852812145 Last Updated: 8/23/2006

Contract Number: H0354 Legal Entity Name: CIGNA HEALTHCARE OF ARIZONA, INC.

Organization Marketing Name: CIGNA Medicare Select Parent Organization: CIGNA

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Medicare Team 12/1/1992 Contract Effective Date: 1-800-627-7534 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:


11001 N. BLACK CANYON HIGHWAY Legal Entity Address: PhoenixCity:

PHOENIX City: AZState: AZState: 85080Zip: 85029 Zip: 3/29/2007Last Updated:

Contract Number: H0370 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO

Organization Marketing Name: Coventry Health and Life Insurance Company Parent Organization: Coventry Health Care Inc.



CMS Region Responsible: Denver Fax: Enrollment: * Email: [email protected]

Address: 3721 TecPort Dr. Legal Entity Address: 4320 114th St.

City: Harrisburg City: Urbandale State: PA

State: IA Zip: 17106 Zip: 50322 Last Updated: 4/9/2008


Contract Number: H0401 Legal Entity Name: UNITEDHEALTHCARE OF ARKANSAS, INC.



Enrollment: 624 [email protected] Email: 5757 Plaza Dr Address:

9900 BREN ROAD EAST Legal Entity Address: CA124-0142 CyressCity:

MINNETONKA City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:





9900 Bren Road East Legal Entity Address: CA124-0142 MN008-T440 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:


Organization Marketing Name: Erickson Advantage Parent Organization: UnitedHealth Group, Inc.

Demo Organization Type: Contact Title: Continuing Care Retirement CommunityPlan Type: Richard IrwinName: 1/1/2007 Contract Effective Date: 1-888-867-5518 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:



Contract Number: H0423 Legal Entity Name: METROPLUS HEALTH PLAN, INC.

Organization Marketing Name: MetroPlus Health Plan Parent Organization: MetroPlus Health Plan, Inc.


160 Water Street 3rd Floor New York NY 10038

Not-for-Profit/Non-Profit New York



City: State:

Zip:


Enrollment: 1,649


Director of Medicare Operations

1-212-908-8744

1-212-908-8620 [email protected] 160 Water Street 3rd Floor New York NY 10038 5/8/2009

Contact Title:

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Fax: Email:

Address:

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Name: Karen Eastmond


Contract Number: H0427 Legal Entity Name: CLEAR CHOICE HEALTH PLANS, INC.

Organization Marketing Name: Clear Choice Health Plans Parent Organization: Clear Choice Health Plans, Inc.

Organization Type: Local CCP Contact Title: Medicare Marketing Manager Plan Type: HMO/HMOPOS Name: Brad Westphal


CMS Region Responsible: Seattle Fax: 1-541-385-3008 Enrollment: * Email: [email protected]

Address: 2965 NE Conners Ave. Legal Entity Address: 2965 NE Conners Ave.

City: Bend City: Bend State: OR

State: OR Zip: 97701 Zip: 97701 Last Updated: 7/10/2008

Contract Number: H0490 Legal Entity Name: MOLINA HEALTHCARE OF OHIO

Organization Marketing Name: Molina Healthcare of Ohio Parent Organization: Molina Healthcare, Inc.,

Local CCP Organization Type: Vice President Contact Title: HMO/HMOPOS Plan Type: Name: Richard G Slaughter 1/1/2009 Contract Effective Date: 1-562-901-1080 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: 1-562-628-2382 Fax:

Enrollment: 13 [email protected] Email: 200 Oceangate Address:

8101 NORTH HIGH STREET SUITE 180Legal Entity Address: Ste. 100 Long Beach City:

COLUMBUS City: CAState: OHState: 90802Zip: 432356609 Zip: 2/19/2008Last Updated:

Contract Number: H0496 Legal Entity Name: SUMMA INSURANCE COMPANY

Organization Marketing Name: SummaCare Parent Organization: Summa Health System

Organization Type: PFFS Contact Title: Director of Marketing Plan Type: PFFS Name: Tracie Kinaitis


CMS Region Responsible: Chicago Fax: 1-330-996-8866 Enrollment: 46 Email: [email protected]

Address: 10 North Main Street Legal Entity Address: 10 N. Main St

P.O. Box 3620 City: Akron City: Akron State: OH

State: OH Zip: 44308 Zip: 44308 Last Updated: 2/9/2009

Contract Number: H0502 Legal Entity Name: CONTRA COSTA HEALTH PLAN

Organization Marketing Name: Contra Costa Health Plan Parent Organization: Contra Costa Health Services

1876 Cost 1876 Cost 7/1/1977

595 CENTER AVENUE SUITE 100 MARTINEZ CA 94553

Not-for-Profit/Non-Profit San Francisco



City: State:

Zip:


Enrollment: 636


Director of Marketing & Member Services

1-925-957-7221

[email protected] 595 Center Aveune Suite 100 Martinez CA 94553 2/27/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Teresa O'Riva


Contract Number: H0504 Legal Entity Name: CALIFORNIA PHYSICIANS' SERVICE

Organization Marketing Name: Blue Shield of California Parent Organization: Blue Shield of California




Address: 6300 Canoga Avenue Legal Entity Address: 6300 CANOGA AVENUE

City: Woodland Hills City: WOODLAND HILLS State: CA

State: CA Zip: 91367 Zip: 91367 Last Updated: 7/9/2007

Contract Number: H0523 Legal Entity Name: AETNA HEALTH OF CALIFORNIA,INC.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Aetna Customer Service 5/1/1986 Contract Effective Date: 1-800-445-1796 Phone: For Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 28,033 [email protected] Email: 151 Farmington Avenue Address:

2409 CAMINO RAMON Legal Entity Address: Hartford City:

SAN RAMON City: CTState: CAState: 06156Zip: 94583 Zip: 8/22/2006Last Updated:

Contract Number: H0524 Legal Entity Name: KAISER FOUNDATION HP, INC.

Organization Marketing Name: Kaiser Permanente Senior Advantage Parent Organization: Kaiser Foundation Health Plan, Inc.



CMS Region Responsible: San Francisco Fax: Enrollment: 706,912 Email: [email protected]

Address: 393 E Walnut St Fl 7 Legal Entity Address: P.O. BOX 12916

City: Pasadena City: OAKLAND State: CA


Contract Number: H0532 Legal Entity Name: WESTERN HEALTH ADVANTAGE

Organization Marketing Name: Western Health Advantage Parent Organization: Western Health Advantage




Address: 2349 Gateway Oaks Drive, Suite 100 Legal Entity Address: 2349 GATEWAY OAKS DRIVE, SUITE 100

City: Sacramento City: SACRAMENTO State: CA



Contract Number: H0540 Legal Entity Name: UNICARE LIFE AND HEALTH INS. COMPANY

Organization Marketing Name: Unicare Life & Health Ins. Company Parent Organization: Wellpoint, Inc.

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Customer Service


CMS Region Responsible: Chicago Fax: Enrollment: 104,786 Email: [email protected]

Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way

CAT201-C004 City: Oxnard City: Thousand Oaks State: CA

State: CA Zip: 93031-9154 Zip: 90362 Last Updated: 7/13/2007

Contract Number: H0542 Legal Entity Name: ALTAMED HEALTH SERVICES CORPORATION

Organization Marketing Name: AltaMed Senior BuenaCare Parent Organization: Altamed Health Services Corporation

National PACE Organization Type: SBC PACE Center Manager Contact Title: National PACE Plan Type: Name: Jhones T Vergara 11/1/2002 Contract Effective Date: 1-323-728-0411 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-323-890-8761 Fax:

Enrollment: 472 [email protected] Email: 5425 E Pomona BlvdAddress:

500 CITADEL DRIVE Legal Entity Address: SUITE 490 Los Angeles City: LOS ANGELES City: CAState: CAState: 90022Zip: 90040 Zip: 6/20/2008Last Updated:

Contract Number: H0543 Legal Entity Name: PACIFICARE OF CALIFORNIA/SECURE HORIZONS




5995 PLAZA DRIVE Legal Entity Address: CA124-0142 CyressCity:

CYPRESS City: CAState: CAState: 90630Zip: 90630 Zip: 4/14/2009Last Updated:

Contract Number: H0544 Legal Entity Name: CAREMORE HEALTH PLAN

Organization Marketing Name: CareMore Health Plan Parent Organization: CareMore Medical Enterprises


12900 Park Plaza Drive SUITE 150 CERRITOS CA 90703




City: State:

Zip:


Enrollment: 32,298


Director of Enrollment and Membership

1-562-741-4366

1-562-741-4407 [email protected] 12900 Park Plaza Drive Suite 150 Cerritos CA 90703 12/29/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Alicia Wheeler


Contract Number: H0545 Legal Entity Name: INTER VALLEY HEALTH PLAN, INC.

Organization Marketing Name: Inter Valley Health Plan Parent Organization: InterValley Health Plan

Organization Type: Local CCP Contact Title: Manager, Enrollment & Reimbursement Plan Type: HMO/HMOPOS Name: Kim Porter



Address: 300 S. Park Ave. Legal Entity Address: 300 SOUTH PARK

PO BOX 6002 City: Pomona City: POMONA State: CA


Contract Number: H0562 Legal Entity Name: HEALTH NET_OF CA

Organization Marketing Name: Health Net of CA Parent Organization: Health Net, Inc.




Address: P.O. Box 10198 Legal Entity Address: 21281 BURBANK BLVD.

BUILDING B City: Van Nuys City: WOODLAND HILLS State: CA


Contract Number: H0564 Legal Entity Name: BLUE CROSS OF CALIFORNIA

Organization Marketing Name: Anthem Blue Cross Parent Organization: Wellpoint, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 6/1/1993 Contract Effective Date: 1-888-230-7338 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:


1 WellPoint Way Legal Entity Address: CAT201-C004 OxnardCity: Thousand Oaks City: CAState: CAState: 93031-9154 Zip: 90362 Zip: 7/13/2007Last Updated:

Contract Number: H0571 Legal Entity Name: CHINESE COMMUNITY HEALTH PLAN

Organization Marketing Name: Chinese Community Health Plan Parent Organization: Chinese Hospital Association


445 Grant Avenue Suite 700 SAN FRANCISCO CA 94108




City: State:

Zip:


Enrollment: 7,282


Member Services Manager

1-415-955-8800 3201 1-415-397-2129 [email protected] 835 Jackson Street

San Francisco CA 94133 11/21/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Irene Louie


Contract Number: H0602 Legal Entity Name: ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION

Organization Marketing Name: Rocky Mountain Health Plans Parent Organization: Rocky Mountain Health Maintenance , Inc.

1876 Cost Organization Type: Contact Title: 1876 Cost Plan Type: Name: RMHP Customer Service 11/1/1977 Contract Effective Date: 1-800-346-4643 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 21,904 [email protected] Email: PO Box 10600 Address:

2775 CROSSROADS BLVD. Legal Entity Address: Grand JunctionCity:

GRAND JUNCTION City: COState: COState: 81502Zip: 81506 Zip: 9/10/2008Last Updated:

Contract Number: H0609 Legal Entity Name: PACIFICARE OF COLORADO, INC

Organization Marketing Name: AARP MedicareComplete from SecureHorizons Parent Organization: UnitedHealth Group, Inc.



6455 YOSEMITE STREET Legal Entity Address: CA124-0142 CyressCity:

GREENWOOD VILLAG City: CAState: COState: 90630Zip: 80111 Zip: 4/14/2009Last Updated:

Contract Number: H0613 Legal Entity Name: TOTAL LONGTERM CARE, INC.

Organization Marketing Name: Total Longterm Care, Inc. Parent Organization: Total Longterm Care, Inc.

Organization Type: National PACE Contact Title: AVP Medicare and Medicaid Compliance Plan Type: National PACE Name: Matthew Zimmerman


CMS Region Responsible: Denver Fax: 1-303-996-1600 Enrollment: 1,312 Email: [email protected]

Address: 200 E. 9th Ave. Legal Entity Address: 200 E. 9TH AVENUE

City: Denver City: DENVER State: CO

State: CO Zip: 80203 Zip: 80203 Last Updated: 12/4/2008










Contract Number: H0621 Legal Entity Name: COLORADO ACCESS

Organization Marketing Name: Colorado Access Parent Organization: Colorado Access

Local CCP Organization Type: Provider Contracting Manager Contact Title: HMO/HMOPOS Plan Type: Name: Tammie Fickas 2/1/2005 Contract Effective Date: 1-720-744-5206 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 3,250 [email protected] Email: 10065 E. Harvard Ave Address:

10065 EAST HARVARD AVENUE Legal Entity Address: Suite 600 SUITE 600 DenverCity: DENVER City: COState: COState: 80231Zip: 80231 Zip: 1/30/2009Last Updated:









Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Richard Irwin






Contract Number: H0630 Legal Entity Name: KAISER FOUNDATION HP OF CO





Address: 2500 S. Havana St. Legal Entity Address: 10350 E Dakota Avenue

PO Box 378066 City: Aurora City: Denver State: CO



Contract Number: H0657 Legal Entity Name: COLORADO CHOICE HEALTH PLANS

Organization Marketing Name: San Luis Valley HMO Parent Organization: HMO Health Plans, Inc.

1876 Cost Organization Type: Medicare Coordinator Contact Title: 1876 Cost Plan Type: Name: Dessa Pottberg 1/1/1994 Contract Effective Date: 1-719-589-3696 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: 1-719-589-4901 Fax:

Enrollment: 558 [email protected] Email: 700 Main Street, Suite 100 Address:

700 Main Street, Suite 100 Legal Entity Address: AlamosaCity:

Alamosa City: COState: COState: 81101Zip: 81101 Zip: 8/23/2006Last Updated:



Local CCP Organization Type: Contact Title: Local PPO Plan Type: Richard IrwinName: 7/1/2004 Contract Effective Date: 1-888-867-5518 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:


9900 BREN ROAD EAST Legal Entity Address: CA124-0142 MN008-W130 CyressCity: MINNETONKA City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H0712 Legal Entity Name: WELLCARE OF CONNECTICUT, INC.

Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc.

Local CCP Organization Type: Director of Regulatory Affairs Contact Title: HMO/HMOPOS Plan Type: Name: Mary Solomon 5/1/2005 Contract Effective Date: 1-888-423-5252 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 3,889 [email protected]: WellCare Health Plans Address:

116 WASHINGTON AVENUE Legal Entity Address: 8735 Henderson Road TampaCity:

NORTH HAVEN City: FLState: CTState: 33634Zip: 06437 Zip: 3/19/2009Last Updated:

Contract Number: H0747 Legal Entity Name: EDUCATORS MUTUAL INSURANCE ASSOCIATION

Organization Marketing Name: Educators Mutual Insurance Association Parent Organization: Educators Mutual Insurance Association

PFFS PFFS 1/1/2008

852 E. Arrowhead Lane

Murray UT 84107

Not-for-Profit/Non-Profit Denver



City: State:

Zip:


Enrollment: 1,879


Pharmacy Benefits Specialist

1-801-262-7475

[email protected] 852 East Arrowhead Lane

Murray UT 84107 1/13/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Nathan D Gedge


Contract Number: H0752 Legal Entity Name: OXFORD HEALTH PLANS (CT), INC.




48 MONROE TURNPIKE Legal Entity Address: CA124-0142 CyressCity:

TRUMBULL City: CAState: CTState: 90630Zip: 061115031 Zip: 4/14/2009Last Updated:

Contract Number: H0755 Legal Entity Name: HEALTH NET OF CONNECTICUT

Organization Marketing Name: Health Net of Connecticut Parent Organization: Health Net, Inc.




Address: One Far Mill Crossing Legal Entity Address: ONE FAR MILL CROSSING

City: Shelton City: SHELTON State: CT







Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road

City: Hartford City: Blue Bell State: CT

State: PA Zip: 06156 Zip: 19422 Last Updated: 12/11/2007

Contract Number: H0806 Legal Entity Name: ALTIUS HEALTH PLANS, INC. (WYOMING)

Organization Marketing Name: Altius Advantra Parent Organization: Coventry Health Care Inc.


10421 South Jordan Gateway Suite 400 South Jordan UT 84095

For Profit Denver



City: State:

Zip:


Enrollment: 62


Director, Medicare Product

1-801-933-3561

1-801-323-6100 [email protected] 10421 South Jordan Gateway Suite 400 South Jordan UT 84095 12/24/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Jamie Moser


Contract Number: H0838 Legal Entity Name: HMO CALIFORNIA

Organization Marketing Name: Brand New Day Parent Organization: Universal Care, Inc

Organization Type: Local CCP Contact Title: VP Operations and Compliance Plan Type: HMO/HMOPOS Name: Connie Snyder



Address: 1600 E Hill Street Legal Entity Address: 1680 EAST HILL STREET

Building 3 City: Signal Hill City: SIGNAL HILL State: AL


Contract Number: H0846 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY

Organization Marketing Name: Advantra« Freedom Parent Organization: Coventry Health Care Inc.

Organization Type: PFFS Contact Title: Customer Service Plan Type: PFFS Name: Advantra Freedom


CMS Region Responsible: Denver Fax: Enrollment: 188,894 Email: [email protected]

Address: Advantra Freedom/Coventry Health Care, Inc Legal Entity Address: 6705 Rockledge Drive Suite 900 PO Box 7154

City: London City: Bethesda State: KY

State: MD Zip: 40742 Zip: 20817 Last Updated: 2/28/2008






Address: 151 Farmington Avenue Legal Entity Address: 1302 Concourse Drive, Suite 402

City: Hartford City: Linthicum State: CT







Address: 151 Farmington Avenue Legal Entity Address: 151 FARMINGTON AVENUE

City: Hartford City: HARTFORD State: CT



Contract Number: H0908 Legal Entity Name: BUCKEYE COMMUNITY HEALTH PLAN, INC.

Organization Marketing Name: Advantage by Buckeye Community Health Plan Parent Organization: Centene Corporation

Local CCP Organization Type: Sr Marketing Analyst Contact Title: HMO/HMOPOS Plan Type: Name: Todd McCollough 1/1/2008 Contract Effective Date: 1-614-220-4900 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-614-221-7680 Fax:

Enrollment: 140 [email protected] Email: 175 South Third Street Address:

U.S. Bank Building, Suite 250 Legal Entity Address: Suite 1200 175 South Third Street Columbus City: Columbus City: OHState: OHState: 43215Zip: 43215 Zip: 9/10/2008Last Updated:

Contract Number: H0913 Legal Entity Name: WELLCARE HEALTH PLANS OF NEW JERSEY, INC.


Organization Type: Local CCP Contact Title: Plan Directory Contact Plan Type: HMO/HMOPOS Name: Mary L Solomon

Contract Effective Date: 1/1/2008 Phone: 1-888-888-9355 Tax Status: For Profit Extension: 3091


Address: 8735 Henderson Road Legal Entity Address: P.O. Box 26011

City: Tampa City: Tampa State: FL

State: FL Zip: 33634 Zip: 336236011 Last Updated: 2/12/2009

Contract Number: H0967 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.


Organization Type: Local CCP Contact Title: Plan Directory Contact Plan Type: Local PPO Name: Mary Solomon


CMS Region Responsible: Atlanta Fax: Enrollment: 769 Email: [email protected]

Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd

Ren 1 City: Tampa City: Tampa State: FL


Contract Number: H0974 Legal Entity Name: HMO MINNESOTA D/B/A BLUE PLUS

Organization Marketing Name: Blue Plus Parent Organization: Blue Cross and Blue Shield of Minnesota

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Customer Service


CMS Region Responsible: Chicago Fax: Enrollment: 820 Email: [email protected]

Address: 3400 Yankee Drive Legal Entity Address: 3400 Yankee Drive

City: Eagan City: Eagan State: MN



Contract Number: H0979 Legal Entity Name: AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC.

Organization Marketing Name: AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. Parent Organization: Dr. Kiran C. Patel

PFFS Organization Type: Contact Title: PFFS Plan Type: Robin Florez Name: 1/1/2008 Contract Effective Date: 1-813-506-6111 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 3,231 [email protected] Email: 5403 N. Church Ave. Address:

140 Stoneridge Drive Suite 480 Legal Entity Address: TampaCity:

ColumbiaCity: FLState: SCState: 33614Zip: 29201 Zip: 10/31/2008Last Updated:

Contract Number: H1013 Legal Entity Name: VISTA HEALTHPLAN OF SOUTH FLORIDA, INC.

Organization Marketing Name: Vista Healthplan of South Florida, Inc. Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: VHP Customer Service



Address: 1340 Concord Terrace Legal Entity Address: 1340 Concord Terrace

City: Sunrise City: Sunrise State: FL


Contract Number: H1016 Legal Entity Name: AVMED, INC

Organization Marketing Name: AvMed Medicare Preferred Parent Organization: AvMed, Inc.


4300 N.W. 89TH BLVD.

GAINESVILLE FL 32606




City: State:

Zip:


Enrollment: 21,360


CARE PLUS HEALTH PLAN H1019


Organization Marketing Name: CarePlus Health Plans, Inc. Humana Inc.Parent Organization: Local CCP HMO/HMOPOS 2/1/1998

11430 NW 20th Street Suite 300 Doral FL 33172




City: State:

Zip:


Enrollment: 62,740


Manager, Medicare Compliance

1-352-372-8400 40832 1-352-337-8820 [email protected] AvMed Health Plans 4300 NW 89 Blvd. Gainesville FL 32606 6/27/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Jacqueline Crews

1-800-457-4708



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H1026 Legal Entity Name: HEALTH OPTIONS, INC

Organization Marketing Name: Health Options, Inc / Blue Cross Blue Shield of FL Parent Organization: Blue Cross and Blue Shield of Florida

Local CCP Organization Type: Manager B - Contact SFlContact Title: HMO/HMOPOS Plan Type: Name: Martha Garcia 8/1/1986 Contract Effective Date: 1-800-926-6565 Phone: For Profit Tax Status: 17321Extension: Atlanta CMS Region Responsible: 1-305-640-4203 Fax:

Enrollment: 23,410 [email protected] Email: 8400 NW 33rd St Address:

4800 Deerwood Campus Parkway Legal Entity Address: Suite 100 MiamiCity:

JacksonvilleCity: FLState: FLState: 33122Zip: 32246 Zip: 4/1/2009Last Updated:

Contract Number: H1032 Legal Entity Name: WELL CARE OF FLORIDA, INC.


Local CCP Organization Type: Plan Directory Contact Contact Title: HMO/HMOPOS Plan Type: Name: Mary Solomon 1/1/2000 Contract Effective Date: 1-888-888-9355 Phone: For Profit Tax Status: 3091Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 79,374 [email protected] Email: 8735 Henderson Road Address:

8735 Henderson Road Legal Entity Address: TampaCity:

TAMPA City: FLState: FLState: 33634Zip: 33634 Zip: 1/9/2009Last Updated:

Contract Number: H1035 Legal Entity Name: FLORIDA HEALTH CARE PLAN, INC.

Organization Marketing Name: Florida Health Care Plan, Inc. Parent Organization: Blue Cross and Blue Shield of Florida


1340 Ridgewood Avenue

Holly Hill FL 32117

For Profit Atlanta



City: State:

Zip:


Enrollment: 14,243


HUMANA MEDICAL PLAN, INC H1036


Organization Marketing Name: Humana Medical Plan, Inc. Humana Inc.Parent Organization: Local CCP HMO/HMOPOS 2/1/1986

3501 SW 160th Avenue

Miramar FL 33027




City: State:

Zip:


Enrollment: 264,278


Manager of Goverment Contracts

1-800-232-0578 4050 1-386-676-7119 [email protected] 1340 Ridgewood Avenue

Holly Hill FL 32117 4/13/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Christine Bartlett

1-800-457-4708



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H1043 Legal Entity Name: FLORIDA PACE CENTERS, INC.

Organization Marketing Name: Florida Pace Centers, Inc. Parent Organization: Florida PACE Centers, Inc.

National PACE Organization Type: Program Director Contact Title: National PACE Plan Type: Name: Karen Wells 1/1/2003 Contract Effective Date: 1-305-751-7223 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-305-762-3847 Fax:

Enrollment: 150 [email protected] Email: 5200 NE 2nd Avenue Address:

MIAMI JEWISH HOME/HOSP. FOR AGED Legal Entity Address: 5200 NORTHEAST SECOND AVENUE MiamiCity: MIAMI City: FLState: FLState: 33137Zip: 33137 Zip: 8/23/2006Last Updated:

Contract Number: H1045 Legal Entity Name: PREFERRED CARE PARTNERS INC.

Organization Marketing Name: Preferred Care Partners, Inc. Parent Organization: Preferred Care Partners Holding Corporation

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Arlen Delgado 8/1/2002 Contract Effective Date: 1-305-670-8440 Phone: For Profit Tax Status: 1253Extension: Atlanta CMS Region Responsible: 1-786-787-0060 Fax:

Enrollment: 20,770 [email protected] Email: 9100 South Dadeland BlvdAddress:

9100 SOUTH DADELAND BLVD. Legal Entity Address: Suite 1250 SUITE 1250 MiamiCity: MIAMI City: FLState: FLState: 33156Zip: 33156 Zip: 11/25/2008Last Updated:

Contract Number: H1076 Legal Entity Name: VISTA HEALTHPLAN, INC.

Organization Marketing Name: Vista Healthplan, Inc. Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: VHP Customer Service






Contract Number: H1080 Legal Entity Name: UNITEDHEALTHCARE OF FLORIDA, INC.





Address: 5757 Plaza Dr Legal Entity Address: 4350 WEST CYPRESS ST. CA124-0142

SUITE 908 City: Cyress City: TAMPA State: CA



Contract Number: H1099 Legal Entity Name: HEALTH FIRST HEALTH PLANS, INC.

Organization Marketing Name: Health First Medicare Plans Parent Organization: Health First

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 4/1/1997 Contract Effective Date: 1-321-434-5665 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 22,836 [email protected] Email: 6450 US Highway 1 Address:

6450 US HIGHWAY 1 Legal Entity Address: RockledgeCity:

ROCKLEDGE City: FLState: FLState: 32955Zip: 329555747 Zip: 9/11/2006Last Updated:






Contract Number: H1109 Legal Entity Name: AETNA HEALTH INC.(GEORGIA)





Address: 151 Farmington Avenue Legal Entity Address: 11675 Great Oaks Way

City: Hartford City: Alpharetta State: CT

State: GA Zip: 06156 Zip: 30022 Last Updated: 8/23/2006







City: Hartford City: Hartford State: CT



Contract Number: H1111 Legal Entity Name: UNITEDHEALTHCARE OF GEORGIA, INC.




9900 Bren Road E Legal Entity Address: CA124-0142 CyressCity:

Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H1112 Legal Entity Name: WELLCARE OF GEORGIA, INC.




8735 Henderson Rd Legal Entity Address: Ren 1 TampaCity: Tampa City: FLState: FLState: 33634Zip: 33634 Zip: 1/11/2009Last Updated:

Contract Number: H1170 Legal Entity Name: KAISER FOUNDATION HP OF GA, INC.





Address: 3495 Piedmont Road NE Legal Entity Address: 3495 PIEDMONT ROAD

BUILDING 9 City: Atlanta City: ATLANTA State: GA

State: GA Zip: 30305 Zip: 30305 Last Updated: 11/21/2008


Organization Marketing Name: Kaiser Permanente Medicare Cost Parent Organization: Kaiser Foundation Health Plan, Inc.

Organization Type: 1876 Cost Contact Title: Plan Type: 1876 Cost Name: Customer Service


CMS Region Responsible: San Francisco Fax: Enrollment: 291 Email: [email protected]

Address: 711 Kapiolani Blvd Legal Entity Address: 711 KAPIOLANI BLVD

City: Honolulu City: HONOLULU State: HI

State: HI Zip: 96813 Zip: 96813 Last Updated: 8/14/2008


Contract Number: H1216 Legal Entity Name: HARMONY HEALTH PLAN OF ILLINOIS, INC.


Organization Type: Local CCP Contact Title: Plan Directory Contact Plan Type: HMO/HMOPOS Name: Mary Solomon



Address: 8735 Henderson Road Legal Entity Address: 23 Public Square

Suite 400 City: Tampa City: Belleville State: FL

State: IL Zip: 33634 Zip: 62220 Last Updated: 1/11/2009



Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 5/1/1986 Contract Effective Date: 1-800-805-2739 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 23,121 [email protected] Email: 711 Kapiolani BlvdAddress:

711 KAPIOLANI BLVD Legal Entity Address: HonoluluCity:

HONOLULU City: HIState: HIState: 96813Zip: 96813 Zip: 8/14/2008Last Updated:

Contract Number: H1234 Legal Entity Name: LIFE ST. FRANCIS

Organization Marketing Name: LIFE St. Francis Parent Organization: Life St. Francis

Organization Type: National PACE Contact Title: Plan Type: National PACE Name: Jill Ann Viggiano


CMS Region Responsible: New York Fax: 1-609-475-4661 Enrollment: * Email: [email protected]

Address: 1435 Liberty St. Legal Entity Address: 1435 Liberty St.

City: Hamilton City: Hamilton State: NJ

State: NJ Zip: 08629 Zip: 08629 Last Updated: 3/18/2009

Contract Number: H1251 Legal Entity Name: HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)

Organization Marketing Name: HMSA's 65C Plus Parent Organization: Hawaii Medical Service Association

1876 Cost 1876 Cost 1/1/1998

10 - GA 818 Keeaumoku St Honolulu HI 96814




City: State:

Zip:


Enrollment: 36,658


Manager

1-800-790-4672

[email protected] 534 - CR 818 Keeaumoku St Honolulu HI 96814 2/7/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Kevin Unger


Contract Number: H1254 Legal Entity Name: UPMC HEALTH BENEFITS, INC.

Organization Marketing Name: UPMC Health Plan Parent Organization: University of Pittsburgh Medical Center

PFFS Organization Type: Medicare Hotline Contact Title: PFFS Plan Type: UPMC Health PlanName: 1/1/2007 Contract Effective Date: 1-877-381-3765 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 7,795 [email protected] Email: 112 Washington PlaceAddress:

One Chatham Center Legal Entity Address: 112 Washington Place PittsburghCity: Pittsburgh City: PAState: PAState: 15219Zip: 15219 Zip: 8/18/2006Last Updated:

Contract Number: H1264 Legal Entity Name: WELLCARE OF TEXAS, INC.










Contract Number: H1302 Legal Entity Name: BLUE CROSS OF IDAHO HLTH SERVICES INC

Organization Marketing Name: Blue Cross of Idaho Parent Organization: Blue Cross of Idaho Health Services, Inc.

Local CCP Local PPO 7/1/2005

3000 E Pine Ave

MERIDIAN ID 83642

Not-for-Profit/Non-Profit Seattle



City: State:

Zip:


Enrollment: 273


Medicare Advantage Customer Service

1-208-395-8205

1-208-387-6811 [email protected] 3000 E. Pine Ave.

Meridian ID 83642 8/27/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Sheri Core








Contract Number: H1304 Legal Entity Name: REGENCE BLUE SHIELD OF IDAHO

Organization Marketing Name: Regence BlueShield Of Idaho Parent Organization: The Regence Group

Local CCP Organization Type: Supr Ind Mktg Contact Title: Local PPO Plan Type: Name: Shane Shown 7/1/2005 Contract Effective Date: 1-888-734-3623 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: Fax:

Enrollment: 5,510 [email protected] Email: 1800 Ninth Ave Address:

201 High Street SE Legal Entity Address: PO Box 12625 SeattleCity: SALEM City: WAState: ORState: 98101-1322 Zip: 97309 Zip: 8/10/2007Last Updated:

Contract Number: H1317 Legal Entity Name: AMERICAN PROGRESSIVE LIFE & HEALTH INSURANCE OF NY

Organization Marketing Name: Universal American Parent Organization: Universal American Corp.


1001 Heathrow Park Lane Suite 5001 Lake Mary FL 32746

For Profit Dallas



City: State:

Zip:


Enrollment: 23


PRIORITY HEALTH H1326


Organization Marketing Name: PriorityMedicarePFFS Spectrum Health System Parent Organization: PFFS PFFS 1/1/2009

1231 East Beltline NE

Grand Rapids MI 49525




City: State:

Zip:


Enrollment: *


Member Services Representative

1-888-445-8699

[email protected] 4888 Loop Central Drive Suite 900 Houston TX 77081 1/24/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Member Services

1-888-389-6648

[email protected] 1231 East Beltline Ave NE

Grand Rapids MI 49525 1/31/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H1340 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ARIZONA, INC.


PFFS Organization Type: Plan Directory Contact Contact Title: PFFS Plan Type: Name: Mary Solomon 1/1/2007 Contract Effective Date: 1-888-888-9355 Phone: For Profit Tax Status: 3091Extension: Atlanta CMS Region Responsible: Fax:


8735 Henderson Rd Ren 2 Legal Entity Address: TampaCity:

Tampa City: FLState: FLState: 33634Zip: 33634 Zip: 4/13/2009Last Updated:

Contract Number: H1350 Legal Entity Name: BLUE CROSS OF IDAHO HEALTH SERVICES, INC


Local CCP Organization Type: Member Services Manager Contact Title: HMO/HMOPOS Plan Type: Name: Sheri Core 9/1/1997 Contract Effective Date: 1-208-395-8205 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-208-387-6811 Fax:

Enrollment: 20,818 [email protected] Email: 3000 E. Pine Ave. Address:

3000 E. PINE AVE. Legal Entity Address: Meridian City:

MERIDIAN City: IDState: IDState: 83642Zip: 83642 Zip: 8/27/2007Last Updated:

Contract Number: H1355 Legal Entity Name: BRAVO HEALTH INSURANCE COMPANY, INC.

Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc.




Address: 3601 O'Donnell Street Legal Entity Address: 3601 O'Donnell Street

City: Baltimore City: Baltimore State: MD


Contract Number: H1356 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY




For Profit Dallas



City: State:

Zip:


Enrollment: 105



1-888-445-8699


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H1364 Legal Entity Name: UNISON HEALTH PLAN OF OHIO, INC.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services Dept 1/1/2008 Contract Effective Date: 1-800-290-4009 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 151 [email protected] Email: Unison Plaza Address:

2800 Corporate Exchange Drive Legal Entity Address: 1001 Brinton Road Suite 200 PittsburghCity: Columbus City: PAState: OHState: 15221Zip: 43231 Zip: 11/13/2008Last Updated:

Contract Number: H1406 Legal Entity Name: HUMANA HEALTH PLAN, INC.

Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 7/1/1985 Contract Effective Date: 1-800-457-4708 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:


201 West Main Street Legal Entity Address: LouisvilleCity:

LouisvilleCity: KYState: KYState: 40202Zip: 40202 Zip: 8/22/2006Last Updated:

Contract Number: H1415 Legal Entity Name: HEALTHSPRING OF TENNESSEE, INC.

Organization Marketing Name: HealthSpring, Inc. Parent Organization: HealthSpring, Inc.

Organization Type: Local CCP Contact Title: Vice President, Customer Service Plan Type: HMO/HMOPOS Name: Wendy Wetzel



Address: 2900 North Loop West Legal Entity Address: 9701 W Higgins Road Suite1300

SUITE 360 City: Houston City: Rosemont State: TX


Contract Number: H1416 Legal Entity Name: HARMONY HEALTH PLAN OF ILLINOIS, INC.





Address: 8735 Henderson Road Legal Entity Address: 125 SOUTH WACKER DRIVE SUITE 2600

City: Tampa City: CHICAGO State: FL





Local CCP Organization Type: Medicare Services Manager Contact Title: Local PPO Plan Type: Name: Jennifer Marquardt 5/1/2005 Contract Effective Date: 1-217-337-8439 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-217-337-3425 Fax:

Enrollment: 3,342 [email protected] Email: 301 S. Vine St. Address:

301 S Vine StLegal Entity Address: PO Box 6003 Urbana City: URBANA City: ILState: ILState: 61801Zip: 61801 Zip: 2/29/2008Last Updated:







Contract Number: H1419 Legal Entity Name: AETNA HEALTH OF ILLINOIS, INC.





Address: 151 Farmington Avenue Legal Entity Address: 100 N. Riverside Plaza, 20th Floor

City: Hartford City: Chicago State: CT













Local CCP Organization Type: Medicare Services Manager Contact Title: HMO/HMOPOS Plan Type: Name: Jennifer Marquardt 10/1/1997 Contract Effective Date: 1-217-337-8439 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-217-337-3425 Fax:

Enrollment: 6,401 [email protected] Email: 301 S. Vine St. Address:

301 S Vine StLegal Entity Address: PO Box 6003 Urbana City: URBANA City: ILState: ILState: 61801Zip: 618013477 Zip: 2/29/2008Last Updated:

Contract Number: H1468 Legal Entity Name: OSF HEALTHPLANS, INC.

Organization Marketing Name: Humana Benefit Plan of Illinois, Inc. Parent Organization: Humana Inc.










Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA124-0142

City: Cyress City: Minnetonka State: CA











Contract Number: H1511 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC.

Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc.




Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037

CAT201-C004 City: Mason City: Thousand Oaks State: OH







Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way



Contract Number: H1553 Legal Entity Name: CLARIAN HEALTH PLANS, INC.

Organization Marketing Name: Clarian Health Plans, Inc. - Senior Smart Choice Parent Organization: The M Plan Inc.

Organization Type: 1876 Cost Contact Title: Customer Solutions Center Manager Plan Type: 1876 Cost Name: Trina Gibson


CMS Region Responsible: Chicago Fax: 1-317-963-9800 Enrollment: 5,114 Email: [email protected]

Address: 1776 N. Meridian Street Legal Entity Address: 1776 N. Meridian, Suite 300 Suite 300

City: Indianapolis City: Indianapolis State: IN

State: IN Zip: 46202 Zip: 46202 Last Updated: 3/18/2009

Contract Number: H1558 Legal Entity Name: WELBORN HEALTH PLAN

Organization Marketing Name: Welborn Health Plans Parent Organization: Welborn Clinic

1876 Cost 1876 Cost 11/1/1997

101 S.E. Third Street

EVANSVILLE IN 47708

For Profit Chicago



City: State:

Zip:


Enrollment: 1,872


Product Manager

1-812-773-0372

1-812-773-0572 [email protected] 101 SE Third St

Evansville IN 47708 4/30/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: David Marx










Contract Number: H1608 Legal Entity Name: COVENTRY HEALTH AND LIFE INS COMPANY





Address: 3721 TecPort Dr. Legal Entity Address: 4320 114th Street



Contract Number: H1609 Legal Entity Name: COVENTRY HEALTH CARE OF IOWA, INC.

Organization Marketing Name: Coventry Health Care of Iowa, Inc. Parent Organization: Coventry Health Care Inc.




Address: 3721 TecPort Dr Legal Entity Address: 4320 114th Street



Contract Number: H1643 Legal Entity Name: HM HEALTH INSURANCE COMPANY

Organization Marketing Name: Highmark Health Insurance Company Parent Organization: Highmark Inc.

PFFS PFFS 1/1/2008

120 Fifth Avenue Suite P5501 Pittsburgh PA 15222

For Profit Philadelphia



City: State:

Zip:


Enrollment: 566


VP, Sr. Products Operations

1-412-544-3186

[email protected] 120 Fifth Avenue Suite P5501 Pittsburgh PA 15222 8/22/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Sally Rich


Contract Number: H1651 Legal Entity Name: MEDICAL ASSOCIATES HEALTH PLAN, INC.

Organization Marketing Name: Medical Associates Health Plan, Inc. Parent Organization: Medical Associates Clinic

1876 Cost Organization Type: Marketing Specialist Contact Title: 1876 Cost Plan Type: Name: Julie Hoffmann 2/1/1996 Contract Effective Date: 1-563-556-8070 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: 1-563-556-5134 Fax:

Enrollment: 8,085 [email protected] Email: 1605 Associates Drive Address:

1605 ASSOCIATES DRIVE Legal Entity Address: Dubuque City:

DUBUQUE City: IAState: IAState: 52002Zip: 52001 Zip: 2/1/2007Last Updated:

Contract Number: H1657 Legal Entity Name: HARMONY HEALTH PLANS OF ILLINOIS, INC.




8735 Henderson Rd., Ren 2 Legal Entity Address: TampaCity:







Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd.




Organization Marketing Name: Anthem Insurance Companies, Inc. Parent Organization: Wellpoint, Inc.








Contract Number: H1714 Legal Entity Name: VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS

Organization Marketing Name: Via Christi HOPE Parent Organization: Via Christi Outreach Pgrm. Elders, Inc

National PACE Organization Type: Center Manager Contact Title: National PACE Plan Type: Name: Dan Kearns 9/1/2002 Contract Effective Date: 1-316-946-5108 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Kansas CityCMS Region Responsible: 1-316-946-5103 Fax:

Enrollment: 176 [email protected] Email: 2622 W Central, Suite 101 Address:

2622 W. Central - Suite 101 Legal Entity Address: WichitaCity:

WICHITA City: KSState: KSState: 67203Zip: 67203 Zip: 3/13/2008Last Updated:











9900 BREN ROAD E. Legal Entity Address: CA124-0142 MN008-T500 CyressCity: MINNETONKA City: CAState: KSState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H1777 Legal Entity Name: CATHOLIC SPECIAL NEEDS PLAN, LLC

Organization Marketing Name: ArchCare Advantage Parent Organization: Catholic Health Care System, Inc.


1339 York Avenue

New York NY 10021




City: State:

Zip:


Enrollment: 561


Director of Operations

1-646-233-5723

1-646-233-5745 [email protected] 155 E 56 ST 2ND FLOOR New York NY 10022 3/24/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Khaibah Stuart




PFFS Organization Type: Contact Title: PFFS Plan Type: Name: Customer Service 1/1/2003 Contract Effective Date: 1-800-457-4708 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:










Contract Number: H1807 Legal Entity Name: UNIVERSITY HEALTH CARE, INC.

Organization Marketing Name: Passport Advantage Parent Organization: University Health Care, Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: PAD Member Services



Address: 305 West Broadway Legal Entity Address: 305 WEST BROADWAY 3rd Floor

THIRD FLOOR City: Louisville City: LOUISVILLE State: KY

State: KY Zip: 40202 Zip: 40202 Last Updated: 8/24/2006

Contract Number: H1837 Legal Entity Name: ESSENCE HEALTHCARE, INC.

Organization Marketing Name: Essence Healthcare Parent Organization: Essence LLP


12655 Olive Boulevard 4th Floor St. Louis MO 63141




City: State:

Zip:


Enrollment: 5,451


Director, Claims and Customer Service

1-314-851-3600

[email protected] 12655

St. Louis MO 63141 1/27/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Dawn Walter


Contract Number: H1846 Legal Entity Name: MOUNT CARMEL HEALTH INSURANCE COMPANY

Organization Marketing Name: MediGold Parent Organization: Trinity Health

Local CCP Organization Type: Provider Relations Call Center Contact Title: Local PPO Plan Type: Name: Provider Call Center 1/1/2009 Contract Effective Date: 1-800-991-9907 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-614-546-4269 Fax:

Enrollment: 461 [email protected] Email: 6150 E. Broad St, EE320 Address:

6150 E. Broad St. EE320 Legal Entity Address: Columbus City:

Columbus City: OHState: OHState: 43213Zip: 43213 Zip: 2/28/2008Last Updated:

Contract Number: H1849 Legal Entity Name: ANTHEM HEALTH PLANS OF KENTUCKY, INC.








Contract Number: H1903 Legal Entity Name: WELLCARE OF LOUISIANA, INC.





Contract Number: H1904 Legal Entity Name: PACE GREATER NEW ORLEANS

Organization Marketing Name: Pace Greater New Orleans Parent Organization: PACE GREATER NEW ORLEANS

National PACE National PACE 9/1/2007

4201 N. Rampart Street

ORLEANS LA 70117

Not-for-Profit/Non-Profit Dallas



City: State:

Zip:


Enrollment: 57


Director of Finance

1-504-945-1531

[email protected] 4201 N RAMPART ST

NEW ORLEANS LA 70117 5/23/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Christophe K Meguess


Contract Number: H1906 Legal Entity Name: HUMANA HEALTH BENEFIT PLAN OF LA, INC.

Organization Marketing Name: Humana Health Benefit Plan of LA, Inc. Parent Organization: Humana Inc.



1 Galleria Boulevard., Suite 850 Legal Entity Address: LouisvilleCity:

Metairie City: KYState: LAState: 40202Zip: 70001 Zip: 2/11/2009Last Updated:





9900 Bren Road East Legal Entity Address: CA124-0142 Mail Route MN-008 W140 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H1951 Legal Entity Name: HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC

Organization Marketing Name: Humana Health Benefit Plan of Louisiana Inc Parent Organization: Humana Inc.




Address: 101 East Main Street Legal Entity Address: 1 Galleria Boulevard., Suite 850

City: Louisville City: Metairie State: KY

State: LA Zip: 40202 Zip: 70001 Last Updated: 8/22/2006

Contract Number: H1961 Legal Entity Name: PEOPLES HEALTH, INC.

Organization Marketing Name: Peoples Health Parent Organization: Tenet Healthcare Corporation



CMS Region Responsible: Dallas Fax: Enrollment: 42,221 Email: [email protected]

Address: Three Lakeway Center Legal Entity Address: Three Lakeway Center 3838 N Causeway Blvd, Suite 2200

3838 N Causeway Blvd., Suite 2200 City: Metairie City: Metairie State: LA



Contract Number: H1991 Legal Entity Name: HORIZON BLUE CROSS BLUE SHIELD OF NJ

Organization Marketing Name: Horizon Blue Cross Blue Shield of New Jersey, Inc. Parent Organization: Horizon Blue Cross Blue Shield of New Jersey, Inc.

Organization Type: PFFS Contact Title: Director, Consumer & Senior Markets Plan Type: PFFS Name: John Selby


CMS Region Responsible: New York Fax: Enrollment: * Email: [email protected]

Address: Three Penn Plaza East , PP-09F Legal Entity Address: 3 Penn Plaza East

City: Newark City: Newark State: NJ












CMS Region Responsible: San Francisco Fax: 1-714-226-6811 Enrollment: 194 Email: [email protected]

Address: 5757 Plaza Dr Legal Entity Address: 450 COLUMBUS BOULEVARD CA124-0142

City: Cyress City: HARTFORD State: CA


Contract Number: H2029 Legal Entity Name: HUMANA INSURANCE OF PUERTO RICO, INC.

Organization Marketing Name: Humana Insurance of Puerto Rico, Inc. Parent Organization: Humana Inc.




Address: 101 East Main Street Legal Entity Address: 383 F.D. Roosevelt Avenue

3rd Floor City: Louisville City: San Juan State: KY



Contract Number: H2034 Legal Entity Name: COMMUNITY CARE HEALTH PLAN, INC.

Organization Marketing Name: Community Care Parent Organization: Community Care, Inc.

Organization Type: Local CCP Contact Title: Marketing Manager Plan Type: HMO/HMOPOS Name: Julie Erdmann



Address: 1555 S. Layton Blvd. Legal Entity Address: 1555 S Layton Blvd

City: Milwaukee City: Milwaukee State: WI




Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Aetna Customer Service 1/1/2008 Contract Effective Date: 1-800-445-1796 Phone: For Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 160 [email protected] Email: 151 Farmington Avenue Address:

151 Farmington Avenue Legal Entity Address: Hartford City:

Hartford City: CTState: PAState: 06156Zip: 06156 Zip: 12/11/2007Last Updated:

Contract Number: H2063 Legal Entity Name: BILLINGS CLINIC

Organization Marketing Name: Billings Clinic PACE Parent Organization: Billings Clinic

National PACE Organization Type: DirectorContact Title: National PACE Plan Type: Anne GonzalezName: 10/1/2008 Contract Effective Date: 1-406-247-6320 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: 1-406-247-6318 Fax:

Enrollment: 21 [email protected] Email: 3155 Avenue C Address:

3155 Avenue C Legal Entity Address: BillingsCity:

Billings City: MTState: MTState: 59012Zip: 59102 Zip: 5/7/2009Last Updated:

Contract Number: H2064 Legal Entity Name: GEISINGER COMMUNITY HEALTH SERVICES

Organization Marketing Name: LIFE Geisinger Parent Organization: Geisinger Health System


100 North Academy Avenue MC 60-65 Danville PA 178226065

Not-for-Profit/Non-Profit Philadelphia



City: State:

Zip:


Enrollment: 107


Director, LIFE Geisinger

1-570-373-2100

1-570-373-2101 [email protected] 100 North Academy Avenue MC 6065 Danville PA 17822-6065 5/14/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Amy L Minnich



Legal Entity Name: BRAVO HEALTH MID- ATLANTIC INC.Organization Marketing Name: Bravo Health

Parent Organization: Bravo Health, Inc.Organization Type: Local CCP Contact Title:

Plan Type: HMO/HMOPOS Name: Customer Service Contract Effective Date: 1/1/2001 Phone: 1-800-556-1570

Tax Status: For Profit Extension: CMS Region Responsible: Philadelphia Fax: 1-410-864-4459

Enrollment: 12,010 Email: [email protected] Address: 3601 O'Donnell Street

Legal Entity Address: 3601 O'Donnell Street City: Baltimore

City: BALTIMORE State: MD State: MD Zip: 21224

Zip: 21224 Last Updated: 8/23/2007 Contract Number: H2109 Legal Entity Name: JOHNS HOPKINS HEALTH SYSTEM, INC.

Organization Marketing Name: Hopkins ElderPlus Parent Organization: Johns Hopkins Health System Corporation

Organization Type: National PACE Contact Title: Director Plan Type: National PACE Name: Karen Armacost


CMS Region Responsible: Philadelphia Fax: 1-410-550-7045 Enrollment: 127 Email: [email protected]

Address: 4940 Eastern Avenue, Mason Lord Bldg., East Tower, First Floor Legal Entity Address: 4940 EASTERN AVENUE

MASON LORD BLDG.,EAST TOWER 1ST FLR City: Baltimore City: BALTIMORE State: MD








City: Cyress City: MINNETONKA State: CA


Contract Number: H2112 Legal Entity Name: AETNA HEALTH INC. (MARYLAND)





Address: 151 Farmington Avenue Legal Entity Address: 1302 Concourse Drive, Suite 402

City: Hartford City: Linthicum State: CT



Contract Number: H2150 Legal Entity Name: KAISER FNDN HP OF THE MID-ATLANTIC STS

Organization Marketing Name: Kaiser Permanente Medicare Plus Parent Organization: Kaiser Foundation Health Plan, Inc.

1876 Cost Organization Type: Member ServicesContact Title: 1876 Cost Plan Type: Name: Daisy Strickland 1/1/1991 Contract Effective Date: 1-888-777-5536 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-301-816-6192 Fax:

Enrollment: 37,025 [email protected] Email: 2101 East Jefferson St, 2nd floor West Address:

2101 EAST JEFFERSON STREET Legal Entity Address: ATTN: Medicare Unit Rockville City:

ROCKVILLE City: MDState: MDState: 20852Zip: 20852 Zip: 11/20/2006Last Updated:

Contract Number: H2169 Legal Entity Name: UPMC HEALTH PLAN INC.


Local CCP Organization Type: Medicare Hotline Contact Title: HMO/HMOPOS Plan Type: UPMC Health PlanName: 1/1/2009 Contract Effective Date: 1-877-381-3765 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 65 [email protected] Email: 112 Washington PlaceAddress:

One Chatham Center Legal Entity Address: 112 Washington Place PittsburghCity: Pittsburgh City: PAState: PAState: 15219Zip: 15219 Zip: 1/31/2008Last Updated:

Contract Number: H2174 Legal Entity Name: TRILLIUM COMMUNITY HEALTH PLAN

Organization Marketing Name: Trillium Advantage Parent Organization: Trillium Community Health Plan

Organization Type: Local CCP Contact Title: Medicare Director Plan Type: HMO/HMOPOS Name: Shannon Conley


CMS Region Responsible: Seattle Fax: 1-541-984-5685 Enrollment: 2,904 Email: [email protected]

Address: 1800 Millrace Drive Legal Entity Address: 1800 Millrace Drive

City: Eugene City: Eugene State: OR







Address: 5757 Plaza Dr Legal Entity Address: c/o UnitedHealth Group/Ovations, 9900 Bren Rd East, CA124-0142

Mail Rout MN008-W840 City: Cyress City: Minnetonka State: CA



Contract Number: H2218 Legal Entity Name: HARBOR HEALTH SERVICES

Organization Marketing Name: Elder Service Plan of Harbor Health Services, Inc Parent Organization: Harbor Health Services, Inc.

National PACE Organization Type: Community Outreach Manager Contact Title: National PACE Plan Type: Name: Lisa Yorra 11/1/2002 Contract Effective Date: 1-617-296-5100 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: 1-617-296-3218 Fax:

Enrollment: 295 [email protected]: 2216 Dorchester Ave Address:

2216 DORCHESTER AVE Legal Entity Address: Dorchester City:

DORCHESTER City: MAState: MAState: 02124Zip: 02124 Zip: 10/30/2007Last Updated:

Contract Number: H2219 Legal Entity Name: FALLON COMMUNITY HEALTH PLAN

Organization Marketing Name: Fallon Community Health Plan - Summit ElderCare Parent Organization: Fallon Community Health Plan

Organization Type: National PACE Contact Title: Director of Operations, Summit ElderCare Plan Type: National PACE Name: Anne Peepas, RN



Address: Two Chestnut Place Legal Entity Address: 10 CHESTNUT STREET 10 Chestnut Street

City: Worcester City: WORCESTER State: MA

State: MA Zip: 01608 Zip: 01608 Last Updated: 5/7/2007

Contract Number: H2220 Legal Entity Name: UPHAMS CORNER HEALTH COMMITTEE, INC.

Organization Marketing Name: Uphams Corner Health Committee, Inc. Parent Organization: Uphams Corner Health Committee, Inc.

National PACE Organization Type: Director of Operations Contact Title: National PACE Plan Type: Jagdeep TrivediName: 11/1/2002 Contract Effective Date: 1-617-288-0970 Phone: Not-for-Profit/Non-Profit Tax Status: 11Extension: Boston CMS Region Responsible: 1-617-474-0757 Fax:

Enrollment: 146 [email protected] Email: 1140 Dorchester Ave. Address:

500 Columbia Road Legal Entity Address: Mail Stop 1140-08 Dorchester City: DORCHESTER City: MAState: MAState: 02125Zip: 02125 Zip: 4/16/2008Last Updated:

Contract Number: H2221 Legal Entity Name: ELDER SRVC PLN/CAMBRIDGE HEALTH ALLIANCE

Organization Marketing Name: Elder Srvc Pln/Cambridge Health Alliance Parent Organization: Cambridge Health Alliance


270 GREEN STREET

CAMBRIDGE MA 02139

Not-for-Profit/Non-Profit Boston



City: State:

Zip:


Enrollment: 200


Financial Analyst ll

1-781-306-8671

1-781-306-8660 [email protected] 270 Green Street

Cambridge MA 02139 5/24/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Estenieau Jean


Contract Number: H2222 Legal Entity Name: ELDER SERVICE PLAN OF THE NORTH SHORE

Organization Marketing Name: Elder Service Plan of the North Shore Parent Organization: Elder Service Plan of the North Shore

Organization Type: National PACE Contact Title: Director Marketing and Enrollment Plan Type: National PACE Name: Linda Leblanc


CMS Region Responsible: Boston Fax: 1-781-715-6699 Enrollment: 588 Email: [email protected]

Address: 37 Friend Street Legal Entity Address: 37 FRIEND STREET

City: Lynn City: LYNN State: MA


Contract Number: H2223 Legal Entity Name: ELDER SVC PLN/E BOSTON HEALTH CENTER

Organization Marketing Name: Elder Svc Pln/E Boston Health Center Parent Organization: Elder Svc Pln/E Boston Health Center

National PACE Organization Type: Marketing Director Contact Title: National PACE Plan Type: Name: Pamela Pattavina 11/1/2003 Contract Effective Date: 1-617-569-5800 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 278 [email protected] Email: 10 Gove St Address:

10 GOVE STREET Legal Entity Address: East Boston City:

EAST BOSTON City: MAState: MAState: 02128Zip: 02128 Zip: 11/9/2006Last Updated:

Contract Number: H2224 Legal Entity Name: SENIOR WHOLE HEALTH, LLC

Organization Marketing Name: Senior Whole Health Parent Organization: Senior Whole Health, LLC

Organization Type: Local CCP Contact Title: VP, Information Technology Plan Type: HMO/HMOPOS Name: Mike Levoshko


CMS Region Responsible: Boston Fax: 1-617-494-5599 Enrollment: 4,865 Email: [email protected]

Address: 58 Charles Street, 2nd Floor Legal Entity Address: 58 Charles Street, 2nd Floor

City: Cambridge City: CAMBRIDGE State: MA


Contract Number: H2225 Legal Entity Name: COMMONWEALTH CARE ALLIANCE, INC.

Organization Marketing Name: Commonwealth Care Alliance, Inc. Parent Organization: Commonwealth Care Alliance

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Kara Curtis



Address: 30 Winter Street Legal Entity Address: 30 WINTER STREET

City: Boston City: BOSTON State: MA




Organization Marketing Name: Evercare« Senior Care Options Parent Organization: UnitedHealth Group, Inc.










Contract Number: H2229 Legal Entity Name: TUFTS ASSOCIATED HMO, INC.

Organization Marketing Name: Tufts Health Plan Parent Organization: TAHMO, Inc.

Local CCP Organization Type: Tufts MP Marketing Communications Manager Contact Title: Local PPO Plan Type: Name: Dana Cutter 8/1/2005 Contract Effective Date: 1-617-972-9400 Phone: Not-for-Profit/Non-Profit Tax Status: 2759Extension: Boston CMS Region Responsible: Fax:

Enrollment: 4,846 [email protected] Email: 705 Mt Auburn St Address:

705 Mt Auburn Street Legal Entity Address: WatertownCity:

Watertown City: MAState: MAState: 02472Zip: 02471 Zip: 5/28/2009Last Updated:


Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.Organization Marketing Name: Blue Cross and Blue Shield of Massachusetts

Parent Organization: Blue Cross and Blue Shield of Massachusetts, Inc. Organization Type: Local CCP Contact Title:

Plan Type: Local PPO Name: Member Services Contract Effective Date: 9/1/2005 Phone: 1-800-200-4255

Tax Status: Not-for-Profit/Non-Profit Extension: CMS Region Responsible: Boston Fax:

Enrollment: 1,486 Email: [email protected] Address: One Enterprise Drive

Legal Entity Address: LANDMARK CENTER, 401 PARK DRIVE City: N. Quincy

City: BOSTON State: MA State: MA Zip: 02171

Zip: 022153326 Last Updated: 8/23/2006


Contract Number: H2237 Legal Entity Name: INDEPENDENT CARE HEALTH PLAN, INC.

Organization Marketing Name: iCare Parent Organization: Independent Care Health Plan Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2007 Contract Effective Date: 1-800-947-6644 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 3,017 [email protected] Email: 1555 N Rivercenter Drive Address:

1555 North River Center Drive Legal Entity Address: Suite 202A Suite 206 MilwaukeeCity: Milwaukee City: WIState: WIState: 53212Zip: 53212 Zip: 3/18/2008Last Updated:

Contract Number: H2256 Legal Entity Name: TUFTS ASSOCIATED HMO, INC.


Local CCP Organization Type: Tufts MP Marketing Communications Manager Contact Title: HMO/HMOPOS Plan Type: Name: Dana Cutter 7/1/1994 Contract Effective Date: 1-617-972-9400 Phone: Not-for-Profit/Non-Profit Tax Status: 2759Extension: Boston CMS Region Responsible: Fax:

Enrollment: 74,653 [email protected] Email: 705 Mt Auburn St Address:

705 Mt Auburn Street Legal Entity Address: WatertownCity:

Watertown City: MAState: MAState: 02472Zip: 02471 Zip: 5/28/2009Last Updated:

Contract Number: H2261 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC.

Organization Marketing Name: Blue Cross and Blue Shield of Massachusetts Parent Organization: Blue Cross and Blue Shield of Massachusetts, Inc.




Address: One Enterprise Drive Legal Entity Address: 401 PARK DRIVE

City: N. Quincy City: BOSTON State: MA


Contract Number: H2291 Legal Entity Name: PROSALUD HMO, CORP.

Organization Marketing Name: ProSalud HMO Corp Parent Organization: Jaahel Group, Inc.


Suite 232, 85 De Diego Avenue

San Juan PR 00967

For Profit New York



City: State:

Zip:


Enrollment: 152


System Information Manager

1-787-200-1101

[email protected] Suite 232, 85 De Diego Avenue

San Juan PR 00927 3/28/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Emmanuel Morales Name:


Contract Number: H2312 Legal Entity Name: HEALTH ALLIANCE PLAN OF MICHIGAN

Organization Marketing Name: HAP Senior Plus Parent Organization: Health Alliance Plan (HAP)

Local CCP Organization Type: Coach/Manager Tech Planning Contact Title: HMO/HMOPOS Plan Type: Name: Cindy Hoffman 1/1/1987 Contract Effective Date: 1-248-443-7511 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 30,687 [email protected] Email: 2850 W. Grand Blvd.Address:

2850 W. GRAND BLVD. Legal Entity Address: DetroitCity:

DETROIT City: MIState: MIState: 48202Zip: 48202 Zip: 8/17/2006Last Updated:

Contract Number: H2318 Legal Entity Name: HENRY FORD HEALTH SYSTEM

Organization Marketing Name: Henry Ford Health System Parent Organization: Henry Ford Health System

National PACE Organization Type: DirectorContact Title: National PACE Plan Type: Name: Linda McCarver 11/1/2003 Contract Effective Date: 1-313-653-2020 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-313-653-2022 Fax:

Enrollment: 183 [email protected] Email: 7800 W Outer Drive Address:

7800 W. OUTER DRIVE, SUITE 240 Legal Entity Address: Suite 240 DetroitCity:

DETROIT City: MIState: MIState: 48235Zip: 48235 Zip: 5/19/2008Last Updated:

Contract Number: H2319 Legal Entity Name: BLUE CROSS BLUE SHIELD OF MICHIGAN

Organization Marketing Name: Blue Cross Blue Shield of Michigan Parent Organization: Blue Cross Blue Shield of Michigan

PFFS PFFS 7/1/2005

600 Lafayette East

Detroit MI 48226




City: State:

Zip:


Enrollment: 276,536


PRIORITY HEALTH H2320


Organization Marketing Name: PriorityMedicare Spectrum Health System Parent Organization: Local CCP HMO/HMOPOS 7/1/2005

1231 EAST BELTLINE AVE N.E.

GRAND RAPIDS MI 49525




City: State:

Zip:


Enrollment: 16,006


1-800-485-4415

[email protected] 27000 West Eleven Mile Road H 404 Southfield MI 48034 7/12/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Customer Inquiry

1-888-389-6648

[email protected] 1231 East Beltline Ave NE

Grand Rapids MI 49525 8/21/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H2322 Legal Entity Name: ALLIANCE HEALTH AND LIFE INSURANCE, CO

Organization Marketing Name: Alliance Medicare PPO Parent Organization: Health Alliance Plan (HAP)

Local CCP Organization Type: Coach/Manager Tech Planning Contact Title: Local PPO Plan Type: Name: Cindy Hoffman 8/1/2005 Contract Effective Date: 1-248-443-7511 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 3,269 [email protected] Email: 2850 W. Grand Blvd.Address:

2850 WEST GRAND BLVD. Legal Entity Address: DetroitCity:

DetroitCity: MIState: MIState: 48202Zip: 48202 Zip: 8/17/2006Last Updated:

Contract Number: H2323 Legal Entity Name: FIDELIS SECURECARE OF MICHIGAN

Organization Marketing Name: Fidelis SecureCare Of Michigan Parent Organization: Fidelis SecureCare

Organization Type: Local CCP Contact Title: Manager - Customer Services-Production Plan Type: HMO/HMOPOS Name: Ronald Rome



Address: 201 Lackawanna Ave Legal Entity Address: 38777 WEST SIX MILE ROAD

Suite 207 City: Scranton City: LIVONIA State: PA

State: MI Zip: 18503 Zip: 48152 Last Updated: 3/13/2009

Contract Number: H2354 Legal Entity Name: HEALTHPLUS OF MICHIGAN

Organization Marketing Name: HealthPlus of Michigan Parent Organization: HealthPlus of Michigan

Local CCP Organization Type: Director of Medicare Services Contact Title: HMO/HMOPOS Plan Type: Jacob CollinsName: 4/1/1997 Contract Effective Date: 1-800-332-9161 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-810-733-1958 Fax:

Enrollment: 11,099 [email protected] Email: 2050 S. Linden Road Address:

2050 S. Linden Road Legal Entity Address: P.O. Box 1700 P.O. BOX 1700 FlintCity: FLINT City: MIState: MIState: 48501-1700 Zip: 485011700 Zip: 3/17/2009Last Updated:

Contract Number: H2386 Legal Entity Name: APPALACHIAN AENCY FOR SENIOR CITIZENS, INC.

Organization Marketing Name: Appalachian Agency for Senior Citizens, Inc, Parent Organization: Appalachian Agency for Senior Citizens, Inc.


P.O.B. 765

Cedar Bluff VA 24609




City: State:

Zip:


Enrollment: 27


Deputy Director

1-276-964-4915

1-276-963-0130 [email protected] P.O.B. 765

Cedar Bluff VA 24609 5/5/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Patrick DeMesa







Contract Number: H2407 Legal Entity Name: UCARE MINNESOTA

Organization Marketing Name: UCare Parent Organization: UCare Minnesota

Local CCP Organization Type: State Programs Member Services Supervisor Contact Title: HMO/HMOPOS Plan Type: Name: Jaimie Parker 11/1/2001 Contract Effective Date: 1-612-676-3456 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 677 [email protected] Email: PO Box 52 Address:

500 Stinson Blvd NE Legal Entity Address: Minneapolis City:

MINNEAPOLIS City: MNState: MNState: 55440Zip: 55413 Zip: 5/25/2007Last Updated:

Contract Number: H2409 Legal Entity Name: MEDICA INSURANCE COMPANY

Organization Marketing Name: Medica Insurance Company Parent Organization: Medica Health Plans

PFFS PFFS 7/1/2005

401 CARLSON PARKWAY

MINNETONKA MN 553055387




City: State:

Zip:


Enrollment: 267


MEDICA HEALTH PLANS H2410


Organization Marketing Name: Medica Health Plans Medica Health Plans Parent Organization: PFFS PFFS 8/1/2005

401 CARLSON PARKWAY

MINNETONKA MN 553055387




City: State:

Zip:


Enrollment: 3,502


1-800-234-8755

[email protected] 401 Carlson Parkway

Minnetonka MN 55305 9/6/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


1-800-234-8755

[email protected] 401 Carlson Parkway

Minnetonka MN 55305 8/23/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:




Organization Marketing Name: Fallon Community Health Plan Parent Organization: Fallon Community Health Plan

Organization Type: Local CCP Contact Title: Sr. Manager Medicare Programs Plan Type: Local PPO Name: Lisa Lashbrook



Address: One Chestnut Place Legal Entity Address: 10 CHESTNUT STREET 10 Chestnut Street

City: Worcester City: WORCESTER State: MA


Contract Number: H2416 Legal Entity Name: PRIMEWEST HEALTH SYSTEM

Organization Marketing Name: PrimeWest Health Parent Organization: PrimeWest Health System

Local CCP Organization Type: Director of Member and Enrollment Services Contact Title: HMO/HMOPOS Plan Type: Name: Pauletta J Gesch 7/1/2005 Contract Effective Date: 1-800-366-2906 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 2,067 [email protected] Email: 2209 Jefferson Street Address:

2209 Jefferson Street Legal Entity Address: Suite 101 Suite 101 AlexandriaCity: ALEXANDRIA City: MNState: MNState: 56308Zip: 56308 Zip: 12/3/2007Last Updated:

Contract Number: H2417 Legal Entity Name: ITASCA MEDICAL CARE

Organization Marketing Name: Itasca Medical Care Parent Organization: Itasca County Health & Human Services

Local CCP Organization Type: Program Director Contact Title: HMO/HMOPOS Plan Type: Brett Skyles Name: 6/1/2005 Contract Effective Date: 1-218-327-5517 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-218-327-5545 Fax:

Enrollment: 468 [email protected] Email: 1219 SE 2nd Ave. Address:

1219 SE 2ND AVENUE Legal Entity Address: Grand Rapids City:

GRAND RAPIDS City: MNState: MNState: 55744Zip: 55744 Zip: 5/15/2007Last Updated:

Contract Number: H2419 Legal Entity Name: SOUTH COUNTRY HEALTH ALLIANCE

Organization Marketing Name: South Country Health Alliance Parent Organization: South Country Health Alliance


110 West Fremont Street

OWATONNA MN 55060




City: State:

Zip:


Enrollment: 1,867


Manager Marketing and Communication

1-507-431-6588

1-507-444-7774 [email protected] 110 West Fremont Street

Owatonna MN 55060 3/30/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Ellen Lewis


Contract Number: H2422 Legal Entity Name: HEALTHPARTNERS, INC.

Organization Marketing Name: HealthPartners Classic MN Senior Health Options Parent Organization: HealthPartners, Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Provider Services



Address: 8170 33rd Avenue South Legal Entity Address: 8100 34TH AVENUE SOUTH PO Box 1309

City: Minneapolis City: BLOOMINGTON State: MN

State: MN Zip: 55440-1309 Zip: 55425 Last Updated: 4/25/2008

Contract Number: H2424 Legal Entity Name: FIRST PLAN OF MINNESOTA

Organization Marketing Name: FirstPlan Blue Parent Organization: Blue Cross and Blue Shield of Minnesota

Local CCP Organization Type: Marketing/Communications Manager Contact Title: HMO/HMOPOS Plan Type: Name: Gardner Lepp 5/1/2005 Contract Effective Date: 1-218-740-2330 Phone: Not-for-Profit/Non-Profit Tax Status: 6707Extension: Chicago CMS Region Responsible: 1-218-727-7247 Fax:

Enrollment: 1,053 [email protected] Email: 525 S Lake Avenue Address:

525 S. LAKE AVE, SUITE 222 Legal Entity Address: Suite 222 DuluthCity:

DULUTH City: MNState: MNState: 55802Zip: 55802 Zip: 4/17/2007Last Updated:

Contract Number: H2425 Legal Entity Name: BLUE PLUS

Organization Marketing Name: Blue Plus Parent Organization: Blue Cross and Blue Shield of Minnesota




Address: 3400 Yankee Drive Legal Entity Address: P.O. BOX 64560

City: Eagan City: ST PAUL State: MN


Contract Number: H2450 Legal Entity Name: MEDICA INSURANCE COMPANY

Organization Marketing Name: Medica Insurance Company Parent Organization: Medica Health Plans

Organization Type: 1876 Cost Contact Title: Plan Type: 1876 Cost Name: Customer Service



Address: 401 Carlson Parkway Legal Entity Address: 401 Carlson Parkway

P.O. BOX 9310 City: Minnetonka City: MINNEAPOLIS State: MN





Local CCP Organization Type: State Programs Member Services Supervisor Contact Title: HMO/HMOPOS Plan Type: Name: Jaimie Parker 1/1/1997 Contract Effective Date: 1-612-676-3456 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:


500 Stinson Blvd NE Legal Entity Address: Minneapolis City:

MINNEAPOLIS City: MNState: MNState: 55440Zip: 55413 Zip: 5/25/2007Last Updated:

Contract Number: H2457 Legal Entity Name: METROPOLITAN HEALTH PLAN

Organization Marketing Name: Metropolitan Health Plan MSHO Parent Organization: Metropolitan Health Plan

Organization Type: Local CCP Contact Title: Government Programs Manager Plan Type: HMO/HMOPOS Name: Susan Sommers



Address: 400 South 4th Street Legal Entity Address: 400 South Fourth Street Suite 201

Suite 201 City: Minneapolis City: Minneapolis State: MN


Contract Number: H2458 Legal Entity Name: MEDICA HEALTH PLANS

Organization Marketing Name: Medica Health Plans Parent Organization: Medica Health Plans





City: Minnetonka City: MINNETONKA State: MN





500 Stinson Boulevard NE

MINNEAPOLIS MN 55413




City: State:

Zip:


Enrollment: 59,409


Medicare Customer Services Supervisor

1-612-676-3471

[email protected] PO Box 52

Minneapolis MN 55440 5/29/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Vatisha Hammick


Contract Number: H2461 Legal Entity Name: BLUE CROSS BLUE SHIELD OF MINNESOTA

Organization Marketing Name: Blue Cross Blue Shield of Minnesota Parent Organization: Blue Cross and Blue Shield of Minnesota

1876 Cost Organization Type: Contact Title: 1876 Cost Plan Type: Name: Customer Service 1/1/1999 Contract Effective Date: 1-888-740-6013 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 747 [email protected] Email: 3400 Yankee Drive Address:

3400 Yankee Drive Legal Entity Address: EaganCity:

Eagan City: MNState: MNState: 55121-1627 Zip: 55122 Zip: 9/11/2006Last Updated:

Contract Number: H2462 Legal Entity Name: GROUP HEALTH INC,

Organization Marketing Name: HealthPartners Freedom Plan Parent Organization: HealthPartners, Inc.

Organization Type: 1876 Cost Contact Title: Plan Type: 1876 Cost Name: Provider Services



Address: 8170 33rd Avenue South Legal Entity Address: 8170 33rd Avenue South PO Box 1309

PO Box 1309 City: Minneapolis City: MINNEAPOLIS State: MN


Contract Number: H2481 Legal Entity Name: MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION

Organization Marketing Name: CareSource Parent Organization: Mid Rogue Community Health Plan

Organization Type: Local CCP Contact Title: Director of Marketing Plan Type: Local PPO Name: Freddy Sennhauser


CMS Region Responsible: Seattle Fax: 1-541-471-1524 Enrollment: 61 Email: [email protected]

Address: 740 SE 7th Street Legal Entity Address: 740 SE 7th Street

City: Grants Pass City: Grants Pass State: OR


Contract Number: H2486 Legal Entity Name: HUMANA MEDICAL PLAN OF UTAH

Organization Marketing Name: Humana Medical Plan of Utah Parent Organization: Humana Inc.



CMS Region Responsible: Kansas City Fax: Enrollment: 359 Email: [email protected]

Address: 101 East Main Street Legal Entity Address: 500 West Main Street

City: Louisville City: Louisville State: KY



Contract Number: H2491 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ARIZONA, INC.



Enrollment: 634 [email protected] Email: 8735 Henderson Road Address:


Contract Number: H2537 Legal Entity Name: LIFE LUTHERAN

Organization Marketing Name: LIFE Lutheran Services, Inc. Parent Organization: Lutheran Social Services of South Central PA

Organization Type: National PACE Contact Title: Executive Director Plan Type: National PACE Name: Mary Fredette


CMS Region Responsible: Philadelphia Fax: 1-717-264-3279 Enrollment: * Email: [email protected]

Address: 840 Fifth Avenue Legal Entity Address: 840 Fifth Avenue

City: Chambersburg City: Chambersburg State: PA






1100 Employers Blvd. Legal Entity Address: LouisvilleCity:


Contract Number: H2609 Legal Entity Name: ALEXIAN BROTHERS COMMUNITY SERVICES

Organization Marketing Name: Alexian Brothers Community Services Parent Organization: Alexian Brothers Community Services

Organization Type: National PACE Contact Title: Marketing Director Plan Type: National PACE Name: Rebecca Boerner


CMS Region Responsible: Kansas City Fax: 1-314-771-7830 Enrollment: 157 Email: [email protected]

Address: 3900 S. Grand Legal Entity Address: 3900 SOUTH GRAND BOULEVARD

City: St. Louis City: ST. LOUIS State: MO

State: MO Zip: 63118 Zip: 63118 Last Updated: 6/14/2007




Local CCP Organization Type: Director, Claims and Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Dawn Walter 6/1/2004 Contract Effective Date: 1-314-851-3600 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:

Enrollment: 19,183 [email protected] Email: 12655Address:

12655 Olive BlvdLegal Entity Address: 4th Floor St. LouisCity: ST. LOUIS City: MOState: MOState: 63141Zip: 63141 Zip: 1/22/2009Last Updated:

Contract Number: H2611 Legal Entity Name: MERCY HEALTH PLANS

Organization Marketing Name: Mercy Health Plans Parent Organization: Sisters of Mercy Health System-St. Louis.

Local CCP Organization Type: Director Customer Contact Centers Contact Title: Local PPO Plan Type: Name: Ed Abrams 1/1/2005 Contract Effective Date: 1-800-919-6459 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: 1-314-214-3268 Fax:

Enrollment: 3,137 [email protected] Email: 14528 S. Outer 40, Ste. 300 Address:

14528 S.OUTER 40, SUITE 300 Legal Entity Address: Chesterfield City:

CHESTERFIELD City: MOState: MOState: 63017Zip: 63017 Zip: 12/12/2007Last Updated:

Contract Number: H2613 Legal Entity Name: HEALTHY ALLIANCE LIFE INSURANCE COMPANY

Organization Marketing Name: Blue Cross Blue Shield of Missouri Parent Organization: Wellpoint, Inc.




Address: 1831 Chestnut Street Legal Entity Address: 1 WellPoint Way M9-5135

CAT201-C004 City: St. Louis City: Thousand Oaks State: MO


Contract Number: H2643 Legal Entity Name: L. A. CARE HEALTH PLAN

Organization Marketing Name: L.A. Care Health Plan Parent Organization: L.A. Care Health Plan


555 West 5th Street 29th Floor Los Angeles CA 90013




City: State:

Zip:


Enrollment: 188


Director Medicare and Product Operations

1-213-694-1250 4187 1-213-438-5736 [email protected] 555 West 5th Street 29th Floor Los Angeles CA 90013 2/20/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Scott A Crawford


Contract Number: H2648 Legal Entity Name: HEALTHNOW NEW YORK, INC.

Organization Marketing Name: Traditional Blue Medicare PFFS Parent Organization: HealthNow New York Inc.

Organization Type: PFFS Contact Title: Division Mgr, Commercial Gov't Programs Plan Type: PFFS Name: Linda Warren



Address: 30 Century Hill Drive Legal Entity Address: 257 West Genesee Street

City: Latham City: Buffalo State: NY

State: NY Zip: 12110 Zip: 14202 Last Updated: 2/28/2007







Contract Number: H2654 Legal Entity Name: UNITEDHEALTHCARE OF THE MIDWEST, INC.




13655 RIVERPORT DRIVE Legal Entity Address: CA124-0142 CyressCity:

MARYLAND HEIGHTS City: CAState: MOState: 90630Zip: 63043 Zip: 4/14/2009Last Updated:

Contract Number: H2663 Legal Entity Name: GROUP HEALTH PLAN, INC.

Organization Marketing Name: Group Health Plan, Inc. Parent Organization: Coventry Health Care Inc.


550 Maryville Centre Drive Suite 300 St. Louis MO 631415818

For Profit Denver



City: State:

Zip:


Enrollment: 27,870


Medicare Marketing Department

1-800-276-2056

[email protected] 550 Maryville Centre Drive Suite 300 St. Louis MO 63141-5818 8/15/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: GHP Medicare Marketing D


Contract Number: H2667 Legal Entity Name: MERCY HEALTH PLANS OF MISSOURI INC.

Organization Marketing Name: Mercy Health Plans of Missouri, Inc. Parent Organization: Sisters of Mercy Health System-St. Louis.

Local CCP Organization Type: Director Customer Contact Centers Contact Title: HMO/HMOPOS Plan Type: Name: Ed Abrams 2/1/1997 Contract Effective Date: 1-800-919-6459 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: 1-314-214-3268 Fax:

Enrollment: 16,226 [email protected] Email: 14528 S. Outer 40, Ste. 300 Address:

14528 S.OUTER 40 ROAD SUITE 300 Legal Entity Address: Chesterfield City:

CHESTERFIELD City: MOState: MOState: 63017Zip: 63017 Zip: 12/12/2007Last Updated:

Contract Number: H2672 Legal Entity Name: COVENTRY HEALTH CARE OF KANSAS, INC.

Organization Marketing Name: Coventry Health Care of Kansas, Inc. Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Manager, Medicare Compliance Plan Type: HMO/HMOPOS Name: Gail D Howard-King



Address: 8320 Ward Parkway Legal Entity Address: 8320 Ward Parkway

City: Kansas City City: KANSAS CITY State: MO


Contract Number: H2699 Legal Entity Name: LIFE AT HOME, LLC

Organization Marketing Name: Life at Home, LLC Parent Organization: LIFE AT HOME, LLC

Organization Type: National PACE Contact Title: Finance Director Plan Type: National PACE Name: Karen M Wells



Address: 101 East State Street Legal Entity Address: 101 E State St.

City: Kennett Square City: Kennett Square State: PA


Contract Number: H2701 Legal Entity Name: NEW WEST HEALTH SERVICES

Organization Marketing Name: New West Health Services Parent Organization: New West Health Services


130 NEILL AVE

HELENA MT 59601




City: State:

Zip:


Enrollment: 2,885


Director of Government Programs

1-406-751-3334

1-406-257-2600 [email protected] 1203 Highway 2 West, Suite 45

Kalispell MT 59901 3/26/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Bonnie Franklin


Contract Number: H2762 Legal Entity Name: CONNECTICUT GENERAL LIFE INSURANCE COMPANY

Organization Marketing Name: CIGNA Medicare Access Parent Organization: CIGNA

PFFS Organization Type: Contact Title: PFFS Plan Type: Doretta AndonucciName: 1/1/2008 Contract Effective Date: 1-800-577-9410 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:

Enrollment: 14,478 [email protected] Email: 900 Cottage Grove Rd Address:

900 Cottage Grove Road Legal Entity Address: Routing B4MKT Hartford City:

Hartford City: CTState: CTState: 06152Zip: 06152 Zip: 3/26/2009Last Updated:



Organization Type: Local CCP Contact Title: Member Services Representative Plan Type: Local PPO Name: Member Services


CMS Region Responsible: Dallas Fax: Enrollment: 130 Email: [email protected]

Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900

Suite 5001 City: Houston City: Lake Mary State: TX


Contract Number: H2788 Legal Entity Name: GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC.

Organization Marketing Name: Medi-CareFirst BlueCross BlueShield Parent Organization: CareFirst, Inc.

Organization Type: PFFS Contact Title: Director, Pharmacy Management Plan Type: PFFS Name: Winston Wong



Address: 1501 S. Clinton St 8th Floor Legal Entity Address: 840 First Street NE

Attn: Jordana Bradley City: Baltimore City: Washington State: MD

State: DC Zip: 21224 Zip: 20065 Last Updated: 5/15/2008

Contract Number: H2802 Legal Entity Name: UNITEDHEALTHCARE OF THE MIDLANDS, INC.





Address: 5757 Plaza Dr Legal Entity Address: 13655 RIVERPORT DRIVE CA124-0142

City: Cyress City: MARYLAND HEIGHTS State: CA








Contract Number: H2815 Legal Entity Name: VOLUNTEERS OF AMERICA NATIONAL SERVICES

Organization Marketing Name: Senior CommUnity Care of Colorado Parent Organization: Volunteers of America National Services

National PACE Organization Type: Executive Director Contact Title: National PACE Plan Type: Name: Gary Snider 8/1/2008 Contract Effective Date: 1-970-901-5020 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 107 [email protected] Email: 2377 Robins Way Address:

2377 Robins Way Legal Entity Address: MontroseCity:

Montrose City: COState: COState: 81401Zip: 81402 Zip: 12/29/2008Last Updated:









Contract Number: H2899 Legal Entity Name: ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC.

Organization Marketing Name: Southeast Community Care Parent Organization: Arcadian Management Services Inc.

Organization Type: Local CCP Plan Type: HMO/HMOPOS

Contract Effective Date: 1/1/2008 Tax Status: For Profit

CMS Region Responsible: Dallas Enrollment: 2,628

Legal Entity Address: 825 Washington St., Suite 300

City: Oakland State: CA

Zip: 94607

Contact Title: Name: Member Service

Phone: 1-800-573-8597 Extension:

Fax: Email: [email protected]

Address: 825 Washington St. Suite 300

City: Oakland State: CA

Zip: 94607 Last Updated: 2/28/2008


Contract Number: H2905 Legal Entity Name: SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.

Organization Marketing Name: Sierra Health and Life Insurance Company, Inc. Parent Organization: UnitedHealth Group, Inc.

Organization Type: Local CCP Contact Title: Network Contract Coordinator Plan Type: Local PPO Name: David Gardineer



Address: P.O. Box 15645 Legal Entity Address: 2724 N. Tenaya Way

City: Las Vegas City: Las Vegas State: NV

State: NV Zip: 89114 Zip: 89128 Last Updated: 3/10/2009

Contract Number: H2906 Legal Entity Name: HOMETOWN HEALTH PLAN

Organization Marketing Name: Senior Care Plus Parent Organization: Renown Health

Organization Type: Local CCP Contact Title: Customer Services Manager Plan Type: Local PPO Name: John Osmond



Address: 830 Harvard Way Legal Entity Address: 830 HARVARD WAY

City: Reno City: RENO State: NV










Contract Number: H2926 Legal Entity Name: PRIMEWEST HEALTH SYSTEM

Organization Marketing Name: PrimeWest Health Parent Organization: PrimeWest Health System


2209 Jefferson Street Suite 101 Alexandria MN 56308




City: State:

Zip:


Enrollment: 186


Director, Marketing & Communications

1-320-335-5215

1-320-335-5315 [email protected] PrimeWest Health System 2209 Jefferson Street, Suite 101 Alexandria MN 56308 2/13/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Beth Hendrickson


HEALTH PLAN OF NEVADA, INC. H2931


Organization Marketing Name: Health Plan of Nevada, Inc. UnitedHealth Group, Inc. Parent Organization: Local CCP HMO/HMOPOS 6/1/1985

2720 NORTH TENAYA WAY P.O. BOX 15645 LAS VEGAS NV 891145645




City: State:

Zip:


Enrollment: 1,038


Network Contract Coordinator

1-702-242-7740

1-702-242-7882 [email protected] P.O. Box 15645

Las Vegas NV 89114 3/10/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

David Gardineer Name:

LIFECIRCLES H2936


Organization Marketing Name: LIFECIRCLES LifeCirclesParent Organization: National PACE National PACE 2/1/2009

560 Seminole Road

Muskegon MI 49444




City: State:

Zip:


Enrollment: 11


Executive Director

1-231-733-8686

[email protected] 560 Seminole RD

Muskegon MI 49444 4/29/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Robert H MillsName:

SENTARA LIFE CARE CORPORATION, INC H2941


Sentara Senior Community CareOrganization Marketing Name: Sentara Health Care (SHC) Parent Organization: National PACE National PACE 11/1/2007

665 NEWTOWN ROAD SUITE 121 VIRGINIA BEACH VA 23462




City: State:

Zip:


Enrollment: 118


1-757-502-7805

[email protected] 665 Newtown Road Suite 121 Virginia Beach VA 23462 12/18/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Laura Gadsby

COVENTRY HEALTH AND LIFE INSURANCE COMPANY H2947


Organization Marketing Name: Advantra PPO Coventry Health Care Inc. Parent Organization: Local CCP Local PPO 1/1/2009

6705 Rockledge Drive Suite 900 Bethesda MD 20817

For Profit Denver



City: State:

Zip:


Enrollment: 260


Director Regulatory Compliance

1-412-577-5442

[email protected] 11 Stanwix Street

Pittsburgh PA 15222 3/11/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Barbara Sellman Name:



Legal Entity Name: HUMANA HEALTH PLAN, INC.Organization Marketing Name: Humana Health Plan, Inc.

Parent Organization: Humana Inc.Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 10/1/1992 Contract Effective Date: 1-800-457-4708 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:





Organization Marketing Name: Senior Care Plus Parent Organization: Renown Health

Organization Type: Local CCP Contact Title: Customer Services Manager Plan Type: HMO/HMOPOS Name: John Osmond



Address: 830 Harvard Way Legal Entity Address: 830 Harvard Way

City: Reno City: RENO State: NV


Contract Number: H2961 Legal Entity Name: HEALTH PLAN OF NEVADA, INC.

Organization Marketing Name: Health Plan of Nevada, Inc. Parent Organization: UnitedHealth Group, Inc.

Local CCP Organization Type: Director, Government Programs/Member Services Contact Title: HMO/HMOPOS Plan Type: Name: David Stuczynski 10/1/1996 Contract Effective Date: 1-702-838-2066 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-702-240-6281 Fax:

Enrollment: 55,329 [email protected] Email: 2716 N. Tenaya Way Address:

2720 N. TENAYA WAY Legal Entity Address: Las Vegas City:

LAS VEGAS City: NVState: NVState: 89128Zip: 89128 Zip: 6/12/2008Last Updated:


Legal Entity Name: ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.Organization Marketing Name: Anthem Blue Cross and Blue Shield

Parent Organization: Wellpoint, Inc. Organization Type: Local CCP Contact Title:

Plan Type: Local PPO Name: Customer Service Contract Effective Date: 1/1/2008 Phone: 1-888-445-8916

Tax Status: For Profit Extension: CMS Region Responsible: Chicago Fax:

Enrollment: 505 Email: [email protected] Address: P.O. Box 9154

Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard

City: Thousand Oaks State: CA State: CA Zip: 93031

Zip: 90362 Last Updated: 7/13/2007


Contract Number: H3011 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF MASS. HMO BLUE, INC.

Organization Marketing Name: Blue Cross and Blue Shield of Massachusetts Parent Organization: Blue Cross and Blue Shield of Massachusetts, Inc.

PFFS Organization Type: Contact Title: PFFS Plan Type: Name: MEMBER SERVICES 1/1/2008 Contract Effective Date: 1-800-200-4255 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 945 [email protected] Email: ONE ENTERPRISE DRIVE Address:

401 PARK DRIVE Legal Entity Address: NORTH QUINCY City:

BOSTON City: MAState: MAState: 02171Zip: 022153326 Zip: 5/1/2007Last Updated:




Enrollment: 661 [email protected]: 101 East Main Street Address:

321 West Main Street, 12th Floor Legal Entity Address: LouisvilleCity:


Contract Number: H3044 Legal Entity Name: NHP OF INDIANA, LLC

Organization Marketing Name: Welborn Health Plans Parent Organization: Welborn Clinic

Local CCP Organization Type: Medicare Product Manager Contact Title: HMO/HMOPOS Plan Type: Name: David Marx 1/1/2008 Contract Effective Date: 1-812-773-0372 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-812-773-0572 Fax:

Enrollment: 1,763 [email protected] Email: 101 S.E. Third Street Address:

c/o Neighborhood Health Providers Legal Entity Address: 521 Fifth Ave, Third Floor Evansville City: New York City: INState: NYState: 47708Zip: 10175 Zip: 1/21/2009Last Updated:

Contract Number: H3057 Legal Entity Name: TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,


PFFS PFFS 1/1/2008

705 Mt Auburn Street

Watertown MA 02471

Not-for-Profit/Non-Profit Boston



City: State:

Zip:


Enrollment: 1,510


Tufts MP Marketing Communications Manager

1-617-972-9400 2759

[email protected] 705 Mt Auburn St

Watertown MA 02472 5/28/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Dana Cutter


Contract Number: H3059 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF NEW MEXICO

Organization Marketing Name: PHYSICIANS HEALTH CHOICE OF NEW MEXICO Parent Organization: PSO Health Services, LLC




Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 Fredericksburg Road

Suite 360 City: San Antonio City: San Antonio State: TX


Contract Number: H3107 Legal Entity Name: OXFORD HEALTH PLANS (NJ), INC.




48 Monroe Turnpike Legal Entity Address: CA124-0142 CyressCity:

Trumbull City: CAState: CTState: 90630Zip: 06611 Zip: 4/14/2009Last Updated:

Contract Number: H3113 Legal Entity Name: OXFORD HEALTH PLANS (NJ), INC.




44 SOUTH BROADWAY Legal Entity Address: CA124-0142 CyressCity:

WHITE PLAINS City: CAState: NYState: 90630Zip: 10601 Zip: 4/14/2009Last Updated:

Contract Number:Legal Entity Name:

Organization Marketing Name:Parent Organization:

Organization Type:Plan Type:

Contract Effective Date:Tax Status:

CMS Region Responsible:Enrollment:


City:State:

Zip:

H3132

AIDS HEALTHCARE FOUNDATION MCO OF FLORIDA, INC.Positive Healthcare Partners AIDS Healthcare Foundation Local CCP Contact Title: HMO/HMOPOS Name: 1/1/2008 Phone: Not-for-Profit/Non-Profit Extension: San Francisco Fax: 159 Email:

Address: 110 SE 6th St., Ste. 1960

City: Fort Lauderdale State: FL Zip: 33301 Last Updated:

Health Plan Adminstrator Michael O'Malley 1-888-456-4715

1-323-436-5034 [email protected] 1001 N. Martel Ave.

LOS ANGELES CA 90046 12/9/2008



Legal Entity Name: AETNA HEALTH, INC.Organization Marketing Name: Aetna Medicare

Parent Organization: Aetna Inc.Organization Type: Local CCP Contact Title:

Plan Type: HMO/HMOPOS Name: Aetna Customer Service Contract Effective Date: 9/1/1993 Phone: 1-800-445-1796

Tax Status: For Profit Extension: CMS Region Responsible: Boston Fax:

Enrollment: 36,624 Email: [email protected] Address: 151 Farmington Avenue

Legal Entity Address: 55 LANE ROAD City: Hartford

City: FAIRFIELD State: CT State: NJ Zip: 06156

Zip: 070041098 Last Updated: 12/11/2007 Contract Number: H3154 Legal Entity Name: HORIZON HEALTHCARE OF NEW JERSEY, INC.

Organization Marketing Name: Horizon Blue Cross Blue Shield of New Jersey, Inc. Parent Organization: Horizon Blue Cross Blue Shield of New Jersey, Inc.

Organization Type: Local CCP Contact Title: Director, Consumer & Senior Markets Plan Type: HMO/HMOPOS Name: John Selby


CMS Region Responsible: New York Fax: Enrollment: 54,763 Email: [email protected]

Address: Three Penn Plaza East , PP-09F Legal Entity Address: 3 PENN PLAZA EAST

City: Newark City: NEWARK State: NJ


Contract Number: H3156 Legal Entity Name: AMERIHEALTH HMO_INC

Organization Marketing Name: AmeriHealth 65 Parent Organization: Independence Blue Cross

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Plan Inquiries


CMS Region Responsible: Philadelphia Fax: Enrollment: 2,080 Email: [email protected]

Address: 1901 Market Street Legal Entity Address: 1901 MARKET STRRET

45 TH FLOOR City: Phila. City: PHILADELPHIA State: PA


Contract Number: H3164 Legal Entity Name: AMERICHOICE OF NEW JERSEY, INC

Organization Marketing Name: AmeriChoice Personal Care Plus Parent Organization: UnitedHealth Group, Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Diana Torres-Soto



Address: Four Gateway Center, 4th floor Legal Entity Address: Four Gateway Center 100 Mulberry Street

4th Floor City: Newark City: Newark State: NJ



Contract Number: H3195 Legal Entity Name: PAN AMERICAN LIFE INSURANCE CO. OF PUERTO RICO INC

Organization Marketing Name: PALIC Medicare Parent Organization: Pan American Life Insurance Company

Organization Type: Local CCP Contact Title: Project Manager Plan Type: Local PPO Name: Janice Albert


CMS Region Responsible: New York Fax: 1-787-999-1250 Enrollment: 165 Email: [email protected]

Address: PO BOX 364865 Legal Entity Address: Metro Office Park 2

Calle 1 Suite 101 City: San Juan City: Guaynabo State: PR


Contract Number: H3204 Legal Entity Name: PRESBYTERIAN HEALTH PLAN

Organization Marketing Name: Presbyterian Senior Care Parent Organization: Presbyterian Healthcare Services

Local CCP Organization Type: VP - Government Programs Contact Title: HMO/HMOPOS Plan Type: Name: Mary Eden 4/1/1986 Contract Effective Date: 1-505-923-5885 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:


2501 BUENA VISTA SE Legal Entity Address: P.O. BOX 27489 Albuquerque City: ALBUQUERQUE City: NMState: NMState: 87125-4789 Zip: 87106 Zip: 4/6/2009Last Updated:

Contract Number: H3206 Legal Entity Name: PRESBYTERIAN INSURANCE COMPANY, INC.

Organization Marketing Name: Presbyterian MediCare PPO Parent Organization: Presbyterian Healthcare Services

Local CCP Organization Type: VP - Government Programs Contact Title: Local PPO Plan Type: Name: Mary Eden 7/1/2005 Contract Effective Date: 1-505-923-5885 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:


P.O. BOX 27489 Legal Entity Address: 2501 BUENA VISTA, S.E. Albuquerque City: ALBUQUERQUE City: NMState: NMState: 87125-4789 Zip: 871257489 Zip: 4/6/2009Last Updated:

Contract Number: H3207 Legal Entity Name: LOVELACE INSURANCE COMPANY

Organization Marketing Name: Lovelace Insurance Company Parent Organization: Ardent Health Services.

Organization Type: Local CCP Contact Title: Medicare Compliance Officer Plan Type: Local PPO Name: Karen L Redman


CMS Region Responsible: Dallas Fax: 1-505-727-5510 Enrollment: 473 Email: [email protected]

Address: 4101 Indian School R. NE Legal Entity Address: 4101 INDIAN SCHOOL ROAD, N.E. Suite 110S

City: Albuquerque City: ALBUQUERQUE State: NM

State: NM Zip: 87111 Zip: 87110 Last Updated: 2/24/2009


Contract Number: H3208 Legal Entity Name: HCSC INSURANCE SERVICES COMPANY

Organization Marketing Name: HISC - Blue Cross Blue Shield of New Mexico Parent Organization: Health Care Service Corporation

Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Customer Service 8/1/2005 Contract Effective Date: 1-800-718-2031 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:


901 South Central Expressway, North BuildingLegal Entity Address: ScrantonCity:

Richardson City: PAState: TXState: 18503Zip: 75080 Zip: 8/22/2006Last Updated:







Contract Number: H3214 Legal Entity Name: FIRST MEDICAL HEALTH PLAN (OF FLORIDA)

Organization Marketing Name: First Medical Health Plan of Florida, Inc. Parent Organization: First Medical Health Plan of Florida, Inc.

Organization Type: Local CCP Contact Title: IT Manager Plan Type: HMO/HMOPOS Name: Carlos Santana



Address: PO Box 260308 Legal Entity Address: P.O. Box 260308

City: Miami City: Miami State: FL

State: FL Zip: 33126-0007 Zip: 331260007 Last Updated: 9/20/2007

Contract Number: H3240 Legal Entity Name: AMERIGROUP NEW JERSEY, INC.

Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Dedicated Services Unit



Address: AMERIGROUP Corporation Legal Entity Address: 399 Thornall Street 4425 Corporation Lane

Ninth Floor City: Virginia Beach City: Edison State: VA




Legal Entity Name: LOVELACE HEALTH SYSTEM, INC.Organization Marketing Name: Lovelace Senior Plan

Parent Organization: Ardent Health Services.Local CCP Organization Type: Compliance Coodinator Contact Title: HMO/HMOPOS Plan Type: Name: Karen Redman 11/1/1993 Contract Effective Date: 1-505-727-5658 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-505-727-5510 Fax:

Enrollment: 27,092 [email protected] Email: 4101 Indian School Rd NEAddress:

ALTURA OFFICE COMPLEX Legal Entity Address: 4101 INDIAN SCHOOL RD. NE Albuquerque City: ALBUQUERQUE City: NMState: NMState: 87110Zip: 87110 Zip: 2/24/2009Last Updated:

Contract Number: H3304 Legal Entity Name: EXCELLUS HEALTH PLAN, INC.

Organization Marketing Name: Excellus Health Plan, Inc. Parent Organization: Lifetime Healthcare, Inc.

Organization Type: 1876 Cost Contact Title: Customer Service Department Plan Type: 1876 Cost Name: * Customer Service



Address: 205 Park Club Lane Legal Entity Address: 205 PARK CLUB LANE

City: Buffalo City: WILLIAMSVILLE State: NY


Contract Number: H3305 Legal Entity Name: MVP HEALTH PLAN, INC.

Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP Health Care, Inc.

Organization Type: Local CCP Contact Title: Sales Manager, Medicare Plan Type: HMO/HMOPOS Name: Catherine Mercury



Address: 220 Alexander St Legal Entity Address: 220 Alexander Ave.

City: Rochester City: Rochester State: NY


Contract Number: H3307 Legal Entity Name: OXFORD HEALTH PLANS (NY), INC.





Address: 5757 Plaza Dr Legal Entity Address: 48 Monroe Turnpike CA124-0142

City: Cyress City: Trumbull State: CA








Address: 151 Farmington Avenue Legal Entity Address: 99 PARK AVENUE

City: Hartford City: NEW YORK State: CT


Contract Number: H3314 Legal Entity Name: HIP OF GREATER NEW YORK

Organization Marketing Name: HIP Health Plan of Greater New York Parent Organization: EmblemHealth Inc.

Organization Type: 1876 Cost Contact Title: Manager, Outbound Customer Service Plan Type: 1876 Cost Name: Willie Horne



Address: 55 Water Street Legal Entity Address: 7 WEST 34TH STREET

City: New York City: NEW YORK State: NY

State: NY Zip: 10041-8190 Zip: 10001 Last Updated: 11/21/2008

Contract Number: H3321 Legal Entity Name: INDEPENDENT LIVING SRVCS OF CENTRAL NY

Organization Marketing Name: Independent Living Srvcs Of Central Ny Parent Organization: Loretto Rest Realty Corporation

National PACE Organization Type: Contact Title: National PACE Plan Type: Name: Ginny Turley 11/1/2002 Contract Effective Date: 1-315-452-5800 Phone: Not-for-Profit/Non-Profit Tax Status: 156Extension: New York CMS Region Responsible: Fax:

Enrollment: 363 [email protected] Email: 100 Malta Lane Address:

100 MALTA LANE Legal Entity Address: North Syracuse City:

NORTH SYRACUSE City: NYState: NYState: 13212Zip: 13212 Zip: 12/19/2007Last Updated:

Contract Number: H3322 Legal Entity Name: SENIOR CARE CONNECTION, INC.

Organization Marketing Name: Senior Care Connection, Inc. Parent Organization: Senior Care Connection, Inc.


504 STATE STREET

SCHENECTADY NY 12305




City: State:

Zip:


Enrollment: 123


VP/DIrector

1-518-831-6349

1-518-382-3398 [email protected] 504 State Street

Schenectady NY 12303 8/21/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Bernadette Hallam


Contract Number: H3327 Legal Entity Name: TOUCHSTONE HEALTH HMO, INC.

Organization Marketing Name: Touchstone Health Parent Organization: Touchstone Health Partnership, Inc

Organization Type: Local CCP Contact Title: Director, Member Services Plan Type: HMO/HMOPOS Name: Adrian Ochoa



Address: 14 Wall Street Legal Entity Address: 14 Wall Street, 9th Floor

City: New York City: New York State: NY


Contract Number: H3328 Legal Entity Name: NEW YORK STATE CATHOLIC HLTH PLAN INC

Organization Marketing Name: Fidelis Care Parent Organization: The New York State Catholic Health Plan, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Adrian Gardner 5/1/2004 Contract Effective Date: 1-800-247-1447 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 4,713 [email protected] Email: 95-25 Queens Boulevard Address:

95-25 QUEENS BOULEVARD Legal Entity Address: Rego ParkCity:

REGO PARK City: NYState: NYState: 11374Zip: 11374 Zip: 8/22/2006Last Updated:

Contract Number: H3329 Legal Entity Name: COMPREHENSIVE CARE MANAGEMENT CORP.

Organization Marketing Name: Comprehensive Care Management Corp. Parent Organization: Bethco Corporation

National PACE Organization Type: Contact Title: National PACE Plan Type: Felice Liburd Name: 11/1/2003 Contract Effective Date: 1-718-944-2106 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 2,006 [email protected] Email: 2275 Olinville Avenue Address:

612 ALLERTON AVENUE Legal Entity Address: BronxCity:

BRONX City: NYState: NYState: 10467Zip: 10467 Zip: 3/17/2009Last Updated:

Contract Number: H3330 Legal Entity Name: HIP OF GREATER NEW YORK

Organization Marketing Name: HIP Medicare HMO Parent Organization: EmblemHealth Inc.


55 Water Street

NEW YORK NY 10041




City: State:

Zip:


Enrollment: 130,439


Manager, Outbound Customer Service

1-800-447-8255

[email protected] 55 Water Street

New York NY 10041-8190 11/18/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Willie Horne


Contract Number: H3331 Legal Entity Name: INDEPENDENT LIVING FOR SENIORS, INC.

Organization Marketing Name: Independent Living For Seniors, Inc. Parent Organization: Rochester General Hospital

Organization Type: National PACE Contact Title: Plan Type: National PACE Name: Tina Farrell-Huber


CMS Region Responsible: New York Fax: 1-585-922-2864 Enrollment: 275 Email: [email protected]

Address: 2066 Hudson Avenue Legal Entity Address: 2066 HUDSON AVENUE

City: Rochester City: ROCHESTER State: NY


Contract Number: H3333 Legal Entity Name: AMERICAN PROGRESSIVE LIFE/HLTH INS.


Organization Type: PFFS Contact Title: Member Services Representative Plan Type: PFFS Name: Member Services







Organization Marketing Name: Excellus Health Plan, Inc Parent Organization: Lifetime Healthcare, Inc.

Organization Type: Local CCP Contact Title: Customer Service Department Plan Type: Local PPO Name: * Customer Service



Address: 205 Park Club Lane Legal Entity Address: 165 Court St.

City: Buffalo City: Rochester State: NY


Contract Number: H3336 Legal Entity Name: NEIGHBORHOOD HEALTH PROVIDERS LLC

Organization Marketing Name: Neighborhood Health Providers Parent Organization: Brookdale University and Hospital

Organization Type: Local CCP Contact Title: Vice President Plan Type: HMO/HMOPOS Name: Audrey Brahamsha



Address: 521 5th Avenue Legal Entity Address: 521 FIFTH AVENUE, THIRD FLOOR Third Floor




Contract Number: H3337 Legal Entity Name: LIBERTY HEALTH ADVANTAGE, INC.

Organization Marketing Name: Liberty Health Advantage Parent Organization: Liberty Health Advantage, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Tobias Germoso 8/1/2005 Contract Effective Date: 1-631-227-3415 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 2,676 [email protected] Email: One Huntington QuadrangleAddress:

1 Huntington Quadrangle, Suite 3N01 Legal Entity Address: Suite 3N01 Melville City:

Melville City: NYState: NYState: 11747Zip: 11747 Zip: 3/19/2009Last Updated:

Contract Number: H3338 Legal Entity Name: NATIONAL HEALTH PLAN NETWORK INC.

Organization Marketing Name: National Health Plan Network Inc. Parent Organization: National Health Plan Network Inc

Organization Type: HCPP - 1833 Cost Contact Title: No contact data submitted Plan Type: HCPP - 1833 Cost Name:

Contract Effective Date: 7/1/2005 Phone:Tax Status: For Profit Extension:

CMS Region Responsible: New York Fax:Enrollment: 178 Email:

Address:Legal Entity Address: 11 PENN PLAZA

SUITE 330 City:City: NEW YORK State:

State: NY Zip:Zip: 10001 Last Updated:

Contract Number: H3342 Legal Entity Name: EMPIRE HEALTHCHOICE ASSURANCE, INC.

Organization Marketing Name: Empire BlueCross BlueShield Parent Organization: Wellpoint, Inc.




Address: P.O. Box 1407 Legal Entity Address: 1 WellPoint Way Church Street Station

CAT201-C004 City: New York City: Thousand Oaks State: NY


Contract Number: H3344 Legal Entity Name: INDEPENDENT HEALTH BENEFITS CORPORATION

Organization Marketing Name: Independent Health Parent Organization: Independent Health Association, Inc.

Organization Type: Local CCP Contact Title: Plan Type: Local PPO Name: Member Services



Address: 511 Farber Lakes Drive Legal Entity Address: 511 FARBER LAKES DRIVE

City: Buffalo City: BUFFALO State: NY





Organization Type: Local CCP Contact Title: Sales Manager Medicare Plan Type: Local PPO Name: Catherine Mercury



Address: 220 Alexander St Legal Entity Address: 220 Alexander St.

City: Rochester City: ROCHESTER State: NY


Contract Number: H3347 Legal Entity Name: ELDERPLAN, INC.

Organization Marketing Name: Elderplan Parent Organization: Elderplan, Inc.

Local CCP Organization Type: AVP Sales Admin., Informatics and Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Lois Faust 1/1/2006 Contract Effective Date: 1-718-759-4080 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-718-921-8824 Fax:

Enrollment: 1,002 [email protected] Email: 6323 Seventh Avenue Address:

6323 SEVENTH AVENUE Legal Entity Address: BrooklynCity:

BROOKLYN City: NYState: NYState: 11220Zip: 112204711 Zip: 2/14/2008Last Updated:



Organization Type: Local CCP Contact Title: Customer Service Department Plan Type: HMO/HMOPOS Name: * Customer Service



Address: 205 Park Club Lane Legal Entity Address: 205 PARK CLUB LANE

City: Buffalo City: Buffalo State: NY




1876 Cost 1876 Cost 1/1/1993

165 COURT STREET

ROCHESTER NY 14647




City: State:

Zip:


Enrollment: 3,001


Customer Service Department

1-800-659-1986

[email protected] 205 Park Club Lane

Buffalo NY 14221 11/20/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: * Customer Service


Contract Number: H3359 Legal Entity Name: MANAGED HEALTH, INC.

Organization Marketing Name: Healthfirst Medicare Plan Parent Organization: HealthFirst, Inc

Local CCP Organization Type: Healthfirst Medicare PlanContact Title: HMO/HMOPOS Plan Type: Name: Customer Service 6/1/1994 Contract Effective Date: 1-888-801-1660 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 82,437 [email protected] Email: 25 Broadway, 9th Floor Address:

25 BROADWAY, 9TH FLOOR Legal Entity Address: New York City:

NEW YORK City: NYState: NYState: 10004Zip: 10004 Zip: 4/9/2008Last Updated:

Contract Number: H3361 Legal Entity Name: WELLCARE_OF NEW YORK, INC.





Address: 8735 Henderson Road Legal Entity Address: P.O.BOX 1652

City: Tampa City: NEWBURGH State: FL


Contract Number: H3362 Legal Entity Name: INDEPENDENT HEALTH ASSOCIATION, INC.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/1996 Contract Effective Date: 1-800-665-1502 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 50,818 [email protected] Email: 511 Farber Lakes Drive Address:

511 FARBER LAKES DRIVE Legal Entity Address: BuffaloCity:

BUFFALO City: NYState: NYState: 14221Zip: 14221 Zip: 1/8/2008Last Updated:

Contract Number: H3366 Legal Entity Name: TOUCHSTONE HEALTH HMO, INC.

Organization Marketing Name: Touchstone Health Parent Organization: Touchstone Health Partnership, Inc


14 Wall Street

New York NY 10005

For Profit New York



City: State:

Zip:


Enrollment: 147


Director, Member Services

1-212-294-1640

1-212-294-8210 [email protected] 14 Wall Street

New York NY 10005 5/20/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Adrian Ochoa



Legal Entity Name: EMPIRE HEALTHCHOICE HMO, INC.Organization Marketing Name: Empire BlueCross BlueShield HMO

Parent Organization: Wellpoint, Inc.Organization Type: Local CCP Contact Title:

Plan Type: HMO/HMOPOS Name: Customer Service Contract Effective Date: 7/1/1996 Phone: 1-800-499-9554

Tax Status: For Profit Extension: CMS Region Responsible: Chicago Fax:

Enrollment: 68,320 Email: [email protected] Address: P.O. Box 1407

Legal Entity Address: 1 WellPoint Way Church Street Station CAT201-C004 City: New York

City: Thousand Oaks State: NY State: CA Zip: 10008

Zip: 90362 Last Updated: 7/13/2007 Contract Number: H3379 Legal Entity Name: UNITEDHEALTHCARE OF NEW YORK, INC.




3803 N ELM ST Legal Entity Address: CA124-0142 CyressCity:

GREENSBORO City: CAState: NCState: 90630Zip: 27455 Zip: 4/14/2009Last Updated:

Contract Number: H3384 Legal Entity Name: HEALTHNOW NEW YORK INC

Organization Marketing Name: Senior Blue Parent Organization: HealthNow New York Inc.

Organization Type: Local CCP Contact Title: Division Mgr, Commercial Gov't Programs Plan Type: HMO/HMOPOS Name: Linda Warren



Address: 30 Century Hill Drive Legal Entity Address: 257 West Genesee Street

City: Latham City: BUFFALO State: NY


Contract Number: H3387 Legal Entity Name: UNITEDHEALTHCARE OF NEW YORK, INC.

Organization Marketing Name: AmeriChoice Personal Care Plus Parent Organization: UnitedHealth Group, Inc.



CMS Region Responsible: San Francisco Fax: Enrollment: 782 Email: [email protected]

Address: 7 HANOVER SQUARE Legal Entity Address: 7 HANOVER SQUARE

5TH FLOOR City: New York City: NEW YORK State: NY



Contract Number: H3388 Legal Entity Name: CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.

Organization Marketing Name: CDPHP Medicare Choices Parent Organization: Capital District Physicians' Health Plan, Inc.

Local CCP Organization Type: Manager, Member Services Contact Title: HMO/HMOPOS Plan Type: Name: Laura Kordas 8/1/1999 Contract Effective Date: 1-518-641-3710 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 20,840 [email protected] Email: 500 Patroon Creek BlvdAddress:

500 Patroon Creek Blvd Legal Entity Address: AlbanyCity:

ALBANY City: NYState: NYState: 12206Zip: 12206 Zip: 2/1/2008Last Updated:

Contract Number: H3404 Legal Entity Name: PARTNERS NATIONAL HEALTH PLANS OF NC INC

Organization Marketing Name: PARTNERS National Health Plans, a BCBSNC company Parent Organization: Blue Cross and Blue Shield of North Carolina

Local CCP Organization Type: Call Center support Contact Title: Local PPO Plan Type: Name: Provider Services 7/1/2005 Contract Effective Date: 1-888-296-9790 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 5,758 [email protected] Email: 5660 University Pkwy Address:

5660 University Parkway Legal Entity Address: Winston Salem City:

WINSTON-SALEM City: NCState: NCState: 27105Zip: 27105 Zip: 2/5/2009Last Updated:







Contract Number: H3415 Legal Entity Name: DAVITA VILLAGEHEALTH INSURANCE OF ALABAMA, INC.

Organization Marketing Name: DaVita VillageHealth Insurance of Alabama, Inc. Parent Organization: Davita Inc


Three Hawthorn Parkway Suite 410 Vernon Hills IL 60061

For Profit Denver



City: State:

Zip:


Enrollment: 100


Sr Manager, Marketing Operations and Communication

1-303-626-6247

1-303-626-6384 [email protected] 1627 Cole Blvd

Lakewood CO 80401 1/14/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Teri Hunt






9900 Bren Road E Legal Entity Address: CA124-0142 MN008-T440 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:









Contract Number: H3449 Legal Entity Name: PARTNERS NATIONAL HEALTH PLANS OF NC, INC.

Organization Marketing Name: PARTNERS National Health Plans, a BCBSNC company Parent Organization: Blue Cross and Blue Shield of North Carolina

Organization Type: Local CCP Contact Title: Call Center support Plan Type: HMO/HMOPOS Name: Provider Services



Address: 5660 University Pkwy Legal Entity Address: 5660 University Parkway

City: Winston Salem City: WINSTON-SALEM State: NC

State: NC Zip: 27105 Zip: 271167509 Last Updated: 2/5/2009

Contract Number: H3456 Legal Entity Name: UNITEDHEALTHCARE OF NORTH CAROLINA, INC.





Address: 5757 Plaza Dr Legal Entity Address: 3803 N Elm Street CA124-0142

City: Cyress City: GREENSBORO State: CA



Contract Number: H3503 Legal Entity Name: HEART OF AMERICA HMO

Organization Marketing Name: Heart of America Health Plan Parent Organization: Heart of America HMO

1876 Cost Organization Type: Marketing Representative Contact Title: 1876 Cost Plan Type: Name: Scott Todahl 1/1/1984 Contract Effective Date: 1-701-776-5848 Phone: Not-for-Profit/Non-Profit Tax Status: 2345Extension: Denver CMS Region Responsible: 1-701-776-5425 Fax:

Enrollment: 475 [email protected] Email: 810 So. Main Avenue Address:

810 SOUTH MAIN STREET Legal Entity Address: RugbyCity:

RUGBY City: NDState: NDState: 58368Zip: 58368 Zip: 7/18/2008Last Updated:

Contract Number: H3518 Legal Entity Name: BLUE CROSS BLUE SHIELD OF FLORIDA, INC.

Organization Marketing Name: Blue Cross and Blue Shield of Florida, Inc. Parent Organization: Blue Cross and Blue Shield of Florida

PFFS Organization Type: Manager B - Contact SFlContact Title: PFFS Plan Type: Name: Martha Garcia 1/1/2008 Contract Effective Date: 1-800-926-6565 Phone: Not-for-Profit/Non-Profit Tax Status: 17321Extension: Atlanta CMS Region Responsible: 1-305-640-4203 Fax:

Enrollment: 1,917 [email protected] Email: 8400 NW 33rd St Address:

4800 Deerwood Campus Parkway Legal Entity Address: Suite 100 DCC 100, 8th Floor MiamiCity: JacksonvilleCity: FLState: FLState: 33122Zip: 32246 Zip: 4/1/2009Last Updated:

Contract Number: H3528 Legal Entity Name: CONNECTICARE, INC.

Organization Marketing Name: ConnectiCare, Inc. Parent Organization: EmblemHealth Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Jennifer Bauer



Address: 175 Scott Swamp Road Legal Entity Address: 175 Scott Swamp Road

City: Farmington City: Farmington State: CT


Contract Number: H3533 Legal Entity Name: ARCADIAN HEALTH PLAN OF NEW YORK, INC.

Organization Marketing Name: Northeast Community Care Parent Organization: Arcadian Management Services Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Member Service



Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington St., Suite 300

City: Oakland City: Oakland State: CA



Contract Number: H3597 Legal Entity Name: AETNA HEALTH






Contract Number: H3613 Legal Entity Name: CONCORDIA CARE

Organization Marketing Name: Concordia Care Parent Organization: Concordia Care

National PACE Organization Type: Project Leader Contact Title: National PACE Plan Type: Name: Anne Messer 11/1/2002 Contract Effective Date: 1-216-791-3580 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 195 [email protected] Email: 2373 Euclid Heights BlvdAddress:

2373 EUCLID HEIGHTS BOULEVARD Legal Entity Address: Cleveland Heights City:

CLEVELAND HEIGHTS City: OHState: OHState: 44106Zip: 441062797 Zip: 4/29/2009Last Updated:

Contract Number: H3614 Legal Entity Name: TRIHEALTH SENIORLINK

Organization Marketing Name: Trihealth Seniorlink Parent Organization: TriHealth SeniorLink

Organization Type: National PACE Contact Title: Marketing/Intake coordinator Plan Type: National PACE Name: Jayne Miller



Address: 619 Oak Street Legal Entity Address: 4750 WESLEY AVENUE

SUITE J City: Cincinnati City: CINCINNATI State: OH











Contract Number: H3620 Legal Entity Name: MCKINLEY LIFE INSURANCE COMPANY

Organization Marketing Name: PrimeTime Health Plan Parent Organization: McKinley Life Insurance Company

Local CCP Organization Type: Compliance Coordinator Contact Title: Local PPO Plan Type: Christine Cunningham Name: 7/1/2005 Contract Effective Date: 1-800-577-5084 Phone: For Profit Tax Status: 34917Extension: Chicago CMS Region Responsible: 1-330-363-3066 Fax:

Enrollment: 926 [email protected] Email: 214 Dartmouth Avenue SW Address:

214 DARTMOUTH AVENUE S.W. Legal Entity Address: CantonCity:

CANTON City: OHState: OHState: 44710Zip: 44710 Zip: 6/22/2007Last Updated:

Contract Number: H3623 Legal Entity Name: AETNA HEALTH, INC.





Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Ave







151 HARTFORD AVENUE Legal Entity Address: Hartford City:

HARTFORD City: CTState: CTState: 06156Zip: 06156 Zip: 8/23/2006Last Updated:

Contract Number: H3653 Legal Entity Name: PARAMOUNT CARE, INC

Organization Marketing Name: Paramount Elite Parent Organization: Promedica Health System


1901 INDIAN WOOD CIRCLE

Maumee OH 43537

For Profit Chicago



City: State:

Zip:


Enrollment: 14,843


Member Services Dept.

1-419-887-2525

[email protected] 1901 Indian Wood Circle

Maumee OH 43537 8/11/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Customer Representative


Contract Number: H3655 Legal Entity Name: COMMUNITY INSURANCE COMPANY








Contract Number: H3659 Legal Entity Name: UNITEDHEALTHCARE OF OHIO, INC.




9200 WORTHINGTON ROAD Legal Entity Address: CA124-0142 CyressCity:

WESTERVILLE City: CAState: OHState: 90630Zip: 430828823 Zip: 4/14/2009Last Updated:

Contract Number: H3660 Legal Entity Name: SUMMACARE INC.

Organization Marketing Name: SummaCare Parent Organization: Summa Health System

Organization Type: Local CCP Contact Title: Director of Marketing Plan Type: HMO/HMOPOS Name: Tracie kinaitis



Address: 10 North Main Street Legal Entity Address: P. O. Box 3620

10 North Main Steet City: Akron City: AKRON State: OH




Organization Type: Local CCP Contact Title: Compliance Coordinator Plan Type: HMO/HMOPOS Name: Christine Cunningham



Address: 214 Dartmouth Avenue SW Legal Entity Address: 2600 SIXTH STREET SW

City: Canton City: CANTON State: OH



Contract Number: H3668 Legal Entity Name: MT. CARMEL HEALTH PLAN, INC.

Organization Marketing Name: MediGold Parent Organization: Trinity Health

Local CCP Organization Type: Provider Relations Call Center Contact Title: HMO/HMOPOS Plan Type: Name: Provider Call Center 3/1/1997 Contract Effective Date: 1-800-991-9907 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-614-546-4269 Fax:

Enrollment: 27,484 [email protected] Email: 6150 E. Broad St, EE320 Address:

6150 East Broad Street, EE320 Legal Entity Address: Columbus City:

Columbus City: OHState: OHState: 43213Zip: 43213 Zip: 10/24/2007Last Updated:


Organization Marketing Name: The Health Plan Parent Organization: Health Plan of the Upper Ohio Valley

Local CCP Organization Type: Director Member Services Contact Title: HMO/HMOPOS Plan Type: Name: Sherry Stanley 3/1/1997 Contract Effective Date: 1-740-695-7682 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-740-695-8103 Fax:

Enrollment: 8,411 [email protected] Email: The Health Plan Address:

52160 National Road East Legal Entity Address: 52160 National Road East St. ClairsvilleCity:

St. ClairsvilleCity: OHState: OHState: 43950Zip: 43950 Zip: 8/23/2006Last Updated:

Contract Number: H3706 Legal Entity Name: GLOBALHEALTH, INC.


Organization Type: Local CCP Contact Title: Member Service Representative Plan Type: HMO/HMOPOS Name: Member Services



Address: 4888 Loop Central Drive Legal Entity Address: 4888 Loop Central Drive Suite 900

SUITE 700 City: Houston City: Houston State: TX


Contract Number: H3708 Legal Entity Name: SELECTCARE OF OKLAHOMA, INC.



4888 Loop Central Drive Suite 700 Houston TX 77081

For Profit Dallas



City: State:

Zip:


Enrollment: 147


Member Service Representative

1-866-230-2513


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:




Organization Marketing Name: HISC - Blue Cross And Blue Shield Of Oklahoma Parent Organization: Health Care Service Corporation

Local CCP Organization Type: Director of Customer Service Contact Title: Local PPO Plan Type: Name: Pat Hall 7/1/2005 Contract Effective Date: 1-800-642-8065 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 1,877 [email protected] Email: 218 W 6th Street Address:

901 South Central Expressway, North BuildingLegal Entity Address: TulsaCity:

Richardson City: OKState: TXState: 74119Zip: 75080 Zip: 9/1/2006Last Updated:

Contract Number: H3749 Legal Entity Name: PACIFICARE OF OKLAHOMA, INC.




7666 E 61ST, #500 Legal Entity Address: CA124-0142 CyressCity:

TULSACity: CAState: OKState: 90630Zip: 74133 Zip: 4/14/2009Last Updated:

Contract Number: H3755 Legal Entity Name: COMMUNITY CARE HMO, INC

Organization Marketing Name: CommunityCare Senior Health Plan Parent Organization: CommunityCare Managed Healthcare Plans of OK, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Pat Hall 5/1/1996 Contract Effective Date: 1-800-642-8065 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-918-594-5260 Fax:

Enrollment: 26,592 [email protected] Email: 218 W 6th Street Address:

218 W. 6TH STREET Legal Entity Address: TulsaCity:

TULSACity: OKState: OKState: 74119Zip: 74119 Zip: 8/22/2006Last Updated:







City:State:

Zip:

H3805 PACIFICARE OF OREGON, INC. AARP MedicareComplete from SecureHorizons UnitedHealth Group, Inc. Local CCP HMO/HMOPOS 1/1/1986 For Profit San Francisco 19,752

7525 S.E. 24TH STREET

MERCER ISLAND WA 98040

Contact Title:Name:

Phone:Extension:

Fax:Email:

Address:

City:State:

Zip:Last Updated:

Richard Irwin 1-888-867-5517



Contract Number: H3809 Legal Entity Name: PROVIDENCE HEALTH SYSTEM - OREGON

Organization Marketing Name: Providence ElderPlace Portland Parent Organization: Providence Health System

National PACE Organization Type: Contact Title: National PACE Plan Type: Rika Bering Name: 11/1/2003 Contract Effective Date: 1-503-215-6556 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-503-215-0685 Fax:

Enrollment: 818 [email protected] Email: 4531 SE Belmont Address:

4531 SE Belmont Legal Entity Address: Suite 100 Suite 100 PortlandCity: PORTLAND City: ORState: ORState: 97215Zip: 97215 Zip: 8/19/2008Last Updated:

Contract Number: H3810 Legal Entity Name: MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION

Organization Marketing Name: CareSource Parent Organization: Mid Rogue Community Health Plan

Local CCP Organization Type: Director of Marketing Contact Title: HMO/HMOPOS Plan Type: Name: Freddy Sennhauser 5/1/2005 Contract Effective Date: 1-888-460-0185 Phone: For Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-541-471-1524 Fax:

Enrollment: 5,254 [email protected] Email: 740 SE 7th Street Address:

740 SE 7th Street Legal Entity Address: Grants Pass City:

GRANTS PASS City: ORState: ORState: 97526Zip: 97526 Zip: 9/20/2007Last Updated:

Contract Number: H3811 Legal Entity Name: SAMARITAN HEALTH PLANS, INC.

Organization Marketing Name: Samaritan Advantage Health Plan Parent Organization: Samaritan Health Services

Organization Type: Local CCP Contact Title: Marketing Manager Plan Type: HMO/HMOPOS Name: Cristie Lynch



Address: 815 NW 9th Street Legal Entity Address: 815 NW 9TH STREET, SUITE 103 Suite 101

3600 NW Samaritan Dr. City: Corvallis City: CORVALLIS State: OR








MN008-T500 City: Cyress City: MINNETONKA State: CA



Contract Number: H3813 Legal Entity Name: ODS HEALTH PLAN, INC.

Organization Marketing Name: ODS Health Plan, Inc. Parent Organization: The ODS Companies (ODS)

Organization Type: Local CCP Contact Title: ODS Advantage Member Services Plan Type: Local PPO Name: Member Services



Address: 601 S.W. Second Ave. Legal Entity Address: 601 SW Second Avenue

City: Portland City: Portland State: OR


Contract Number: H3814 Legal Entity Name: ATRIO HEALTH PLANS

Organization Marketing Name: ATRIO MyAdvantage Parent Organization: ATRIO Health Plans

Local CCP Organization Type: Marketing Manager Contact Title: HMO/HMOPOS Plan Type: Name: Rose Novak 7/1/2005 Contract Effective Date: 1-541-672-8620 Phone: For Profit Tax Status: 5386Extension: Seattle CMS Region Responsible: 1-541-672-8670 Fax:

Enrollment: 3,807 [email protected] Email: 500 SE Cass Ave. Address:

500 SE CASS AVE Legal Entity Address: Suite 230 Suite 230 Roseburg City: ROSEBURG City: ORState: ORState: 97470Zip: 97470 Zip: 2/20/2009Last Updated:

Contract Number: H3815 Legal Entity Name: CITIZENS CHOICE HEALTHPLAN

Organization Marketing Name: Citizens Choice Healthplan Parent Organization: Honored Citizens Choice Health Plan

Organization Type: Local CCP Contact Title: Chief Operations Officer Plan Type: HMO/HMOPOS Name: Elizabeth Tejada



Address: 17315 Studebaker Road Suite 200 Legal Entity Address: 17315 Studebaker Road

Suite 200 City: Cerritos City: Cerritos State: CA


Contract Number: H3817 Legal Entity Name: REGENCE BLUECROSS BLUESHIELD OF OR

Organization Marketing Name: Regence BlueCross BlueShield of Oregon Parent Organization: The Regence Group


P.O. Box 12625 201 High Street SE SALEM OR 97309




City: State:

Zip:


Enrollment: 59,672


Supr Ind Mktg

1-888-734-3623

[email protected] 1800 Ninth Ave

Seattle WA 98101-1322 12/17/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Shane Shown


Contract Number: H3818 Legal Entity Name: FAMILYCARE HEALTH PLANS, INC.

Organization Marketing Name: FamilyCare Health Plans, Inc. Parent Organization: FamilyCare Incorporated

Local CCP Organization Type: Marketing Program Specialist Contact Title: HMO/HMOPOS Plan Type: Miguel Villarreal Name: 9/1/2005 Contract Effective Date: 1-503-471-2116 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-503-471-2162 Fax:

Enrollment: 2,327 [email protected] Email: 825 NE Multnomah, Suite 300 Address:

825 NE MULTNOMAH, SUITE 300 Legal Entity Address: PortlandCity:

PORTLAND City: ORState: ORState: 97232Zip: 97232 Zip: 12/11/2008Last Updated:

Contract Number: H3864 Legal Entity Name: CLEAR CHOICE HEALTH PLANS, INC.

Organization Marketing Name: Clear One Health Plans Parent Organization: Clear Choice Health Plans, Inc.

Organization Type: Local CCP Contact Title: Medicare Marketing Manager Plan Type: HMO/HMOPOS Name: Brad Westphal



Address: 2965 NE Conners Ave. Legal Entity Address: 2965 NE Conners Ave.

City: Bend City: BEND State: OR







Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA124-0142

MN008-T440 City: Cyress City: Minnetonka State: CA


Contract Number: H3907 Legal Entity Name: UNIVERSITY OF PITTSBURGH MEDICAL CENTER


Organization Type: Local CCP Contact Title: Medicare Hotline Plan Type: HMO/HMOPOS Name: UPMC Health Plan



Address: 112 Washington Place Legal Entity Address: ONE CHATHAM CENTER

112 WASHINGTON PLACE City: Pittsburgh City: PITTSBURGH State: PA



Contract Number: H3908 Legal Entity Name: TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA

Organization Marketing Name: Trustees Of The University Of Pennsylvania Parent Organization: Trustees of the University of Pennsylvania

National PACE Organization Type: Executive Director Contact Title: National PACE Plan Type: Wayne Pendelton Name: 1/1/2002 Contract Effective Date: 1-215-898-4417 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 344 [email protected] Email: 4508 Chestnut Street Address:

4508 Chestnut Street Legal Entity Address: PhiladelphiaCity:

PHILADELPHIA City: PAState: PAState: 19139Zip: 19139 Zip: 5/21/2007Last Updated:

Contract Number: H3909 Legal Entity Name: QCC INSURANCE COMPANY

Organization Marketing Name: Personal Choice 65 Parent Organization: Independence Blue Cross

Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Plan Inquiries 1/1/2002 Contract Effective Date: 1-800-331-0017 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 14,849 [email protected] Email: 1901 Market Street Address:

1901 MARKET STREET Legal Entity Address: 28TH FLOOR PhiladelphiaCity: PHILADELPHIA City: PAState: PAState: 19103Zip: 191031480 Zip: 9/6/2007Last Updated:






Contract Number: H3916 Legal Entity Name: HIGHMARK, INC.

Organization Marketing Name: Highmark Inc. Parent Organization: Highmark Inc.

Organization Type: Local CCP Contact Title: VP, Sr. Products Operations Plan Type: Local PPO Name: Sally Rich



Address: 120 Fifth Avenue Legal Entity Address: FIFTH AVENUE PLACE - SUITE P5501 Suite P5501

120 FIFTH AVENUE City: Pittsburgh City: PITTSBURGH State: PA



Contract Number: H3917 Legal Entity Name: PITTSBURGH CARE PARTNERSHIP, INC.

Organization Marketing Name: Community LIFE Parent Organization: Pittsburgh Care Partnership, Inc.

National PACE Organization Type: OUTREACH COORDINATOR Contact Title: National PACE Plan Type: Name: STACI KACZKOWSKI 3/1/2004 Contract Effective Date: 1-412-436-1338 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-412-473-6797 Fax:

Enrollment: 306 [email protected] Email: SUITE # 700 Address:

2400 ARDMORE BOULEVARD, SUITE 700 Legal Entity Address: 2400 ARDMORE BOULEVARD PITTSBURGH City:

PITTSBURGH City: PAState: PAState: 15221Zip: 15221 Zip: 12/13/2007Last Updated:

Contract Number: H3918 Legal Entity Name: LIVING INDEPENDENCE FOR THE ELDERLY

Organization Marketing Name: LIFE Pittsburgh Parent Organization: Living Independence for the Elderly

National PACE Organization Type: Director of FinanceContact Title: National PACE Plan Type: Name: Laura Schmitt 5/1/2005 Contract Effective Date: 1-412-388-8042 Phone: Not-for-Profit/Non-Profit Tax Status: 8042Extension: Philadelphia CMS Region Responsible: 1-412-388-8055 Fax:

Enrollment: 316 [email protected] Email: 875 Greentree Rd, One Parkway Center, Suite 200 Address:

875 Greentree Road. Legal Entity Address: One Parkway Center, Suite 200 PittsburghCity: PITTSBURGH City: PAState: PAState: 15220Zip: 15220 Zip: 9/12/2006Last Updated:

Contract Number: H3919 Legal Entity Name: ST. AGNES CONTINUING CARE CENTER

Organization Marketing Name: Mercy LIFE Parent Organization: St. Agnes Continuing Care Center

Organization Type: National PACE Contact Title: Director, Outreach and Enrollment Plan Type: National PACE Name: Erin Oldt



Address: 1900 S. Broad Street Legal Entity Address: 1900 South Broad Street

City: Philadelphia City: PHILADELPHIA State: PA


Contract Number: H3920 Legal Entity Name: UNISON HEALTH PLAN OF PENNSYLVANIA, INC.





Address: Unison Plaza Legal Entity Address: 1001 Brinton Road 1001 Brinton Road

City: Pittsburgh City: Pittsburgh State: PA







9900 BREN ROAD EAST Legal Entity Address: CA124-0142 MN008-T440 CyressCity: MINNETONKA City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H3923 Legal Entity Name: CAPITAL ADVANTAGE INSURANCE COMPANY

Organization Marketing Name: Capital Advantage Insurance Company Parent Organization: Capital BlueCross

Local CCP Organization Type: Customer Service Manager Contact Title: Local PPO Plan Type: Jayne DaileyName: 9/1/2005 Contract Effective Date: 1-800-779-6962 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 9,561 [email protected] Email: 2500 Elmerton Avenue Address:

2500 ELMERTON AVENUE Legal Entity Address: Harrisburg City:

HARRISBURG City: PAState: PAState: 17177Zip: 17177 Zip: 5/27/2009Last Updated:

Contract Number: H3924 Legal Entity Name: GEISINGER INDEMNITY INSURANCE COMPANY

Organization Marketing Name: Geisinger Gold Parent Organization: Geisinger Health System

Local CCP Organization Type: Director of Customer Service Contact Title: Local PPO Plan Type: Renee BlasiName: 9/1/2005 Contract Effective Date: 1-800-498-9731 Phone: For Profit Tax Status: 16159Extension: Philadelphia CMS Region Responsible: 1-570-271-5970 Fax:

Enrollment: 1,247 [email protected] Email: 100 North Academy Avenue Address:

100 NORTH ACADEMY AVE. Legal Entity Address: DanvilleCity:

DANVILLE City: PAState: PAState: 17822-3229 Zip: 178223220 Zip: 11/11/2007Last Updated:

Contract Number: H3925 Legal Entity Name: PENNSYLVANIA PACE, INC.

Organization Marketing Name: Senior LIFE Johnstown Parent Organization: Pennsylvania PACE, Inc.


209 Sigma Drive

Pittsburgh PA 15238




City: State:

Zip:


Enrollment: 149


Cheif Executive Officer

1-814-535-6000 101 1-814-248-7902 [email protected] 401 Broad Street

Johnstown PA 15906 5/16/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Mark IrwinName:


Contract Number: H3931 Legal Entity Name: AETNA HEALTH INC








Contract Number: H3942 Legal Entity Name: ELDERHAUS INC.

Organization Marketing Name: Elderhaus PACE Parent Organization: Elderhaus Inc.

Organization Type: National PACE Contact Title: CFO / PACE PROGRAM DIRECTOR Plan Type: National PACE Name: Larry Reinhart


CMS Region Responsible: Atlanta Fax: 1-910-343-8836 Enrollment: 24 Email: [email protected]

Address: 1950 Amphitheater Dr. Legal Entity Address: 1950 Amphitheater Drive

City: Wilmington City: Wilmington State: NC


Contract Number: H3949 Legal Entity Name: BRAVO HEALTH PENNSYLVANIA INC.





Address: 3601 O'Donnell Street Legal Entity Address: 1500 Spring Garden Street, Suite 800

City: Baltimore City: PHILADELPHIA State: MD


Contract Number: H3952 Legal Entity Name: KEYSTONE HEALTH PLAN EAST, INC.

Organization Marketing Name: Keystone 65 Parent Organization: Independence Blue Cross

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Plan Inquiries



Address: 1901 Market Street Legal Entity Address: 1901 MARKET STREET

45TH FLOOR City: Phila City: PHILADELPHIA State: PA



Contract Number: H3954 Legal Entity Name: GEISINGER HEALTH PLAN


Local CCP Organization Type: Director of Customer Service Contact Title: HMO/HMOPOS Plan Type: Renee BlasiName: 3/1/1994 Contract Effective Date: 1-800-498-9731 Phone: Not-for-Profit/Non-Profit Tax Status: 16159Extension: Philadelphia CMS Region Responsible: 1-570-271-5970 Fax:

Enrollment: 35,081 [email protected] Email: 100 North Academy Avenue Address:

100 NORTH ACADEMY AVENUE Legal Entity Address: DanvilleCity:

DANVILLE City: PAState: PAState: 17822-3229 Zip: 178223220 Zip: 12/14/2007Last Updated:

Contract Number: H3957 Legal Entity Name: KEYSTONE HEALTH PLAN WEST, INC.

Organization Marketing Name: Keystone Health Plan West, Inc. Parent Organization: Highmark Inc.

Organization Type: Local CCP Contact Title: VP, Sr. Products Operations Plan Type: HMO/HMOPOS Name: Sally Rich



Address: 120 Fifth Avenue Legal Entity Address: 120 5TH AVENUE Suite P5501

SUITE 3152 City: Pittsburgh City: PITTSBURGH State: PA


Contract Number: H3959 Legal Entity Name: HEALTHAMERICA PENNSYLVANIA, INC.

Organization Marketing Name: HealthAmerica Advantra Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Director, Regulatory Compliance Plan Type: HMO/HMOPOS Name: Barbara Sellman



Address: 11 Stanwix Street Legal Entity Address: 11 Stanwix Street Suite 2300

City: Pittsburgh City: PITTSBURGH State: PA


Contract Number: H3962 Legal Entity Name: KEYSTONE HEALTH PLAN CENTRAL,INC.

Organization Marketing Name: Keystone Health Plan Central, Inc. Parent Organization: Capital BlueCross

Organization Type: Local CCP Contact Title: Customer Service Manager Plan Type: HMO/HMOPOS Name: Jayne Dailey



Address: 2500 Elmerton Avenue Legal Entity Address: P.O. Box 779827

City: Harrisburg City: HARRISBURG State: PA



Contract Number: H3964 Legal Entity Name: BRAVO HEALTH PENNSYLVANIA, INC.

Organization Marketing Name: Senior Partners Parent Organization: Bravo Health, Inc.







Contract Number: H4003 Legal Entity Name: MMM HEALTHCARE, INC.

Organization Marketing Name: Medicare y Mucho Mßs Parent Organization: Aveta, LLC.

Local CCP Organization Type: Provider AVP Contact Title: HMO/HMOPOS Plan Type: Brenda RiveraName: 9/1/2001 Contract Effective Date: 1-787-622-3000 Phone: For Profit Tax Status: 6703Extension: New York CMS Region Responsible: 1-787-622-0485 Fax:

Enrollment: 129,381 [email protected] Email: 350 Avenida Chard≤nAddress:

350 Chardon Ave Suite 500 Legal Entity Address: Torre Chard≤n, Suite 500 Torre Chardon San JuanCity: San Juan City: PRState: PRState: 00918-2137 Zip: 009182137 Zip: 5/9/2008Last Updated:

Contract Number: H4004 Legal Entity Name: PREFERRED MEDICARE CHOICE, INC.

Organization Marketing Name: Preferred Medicare Choice, Inc. Parent Organization: Aveta, LLC.

Local CCP Organization Type: Provider AVP Contact Title: HMO/HMOPOS Plan Type: Brenda J RiveraName: 8/1/2004 Contract Effective Date: 1-787-622-3000 Phone: For Profit Tax Status: 6703Extension: New York CMS Region Responsible: 1-787-622-0485 Fax:

Enrollment: 52,367 [email protected] Email: 350 Avenida Chard≤nAddress:

350 Chard≤n Avenue Legal Entity Address: Torre Chard≤n, Suite 500 Suite 500, Torre Chard≤n San JuanCity: San Juan City: PRState: PRState: 00918Zip: 009182137 Zip: 5/9/2008Last Updated:

Contract Number: H4005 Legal Entity Name: TRIPLE-S SALUD, INC.

Organization Marketing Name: Triple-S Salud, Inc. Parent Organization: Triple-S Management Corporation


PO BOX 363628

SAN JUAN PR 009363628

For Profit New York



City: State:

Zip:


Enrollment: 35,118


Customer Service Manager

1-800-510-0722 5471

[email protected] 1441 Franklin D. Roosevelt Ave.

San Juan PR 00920 8/25/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Armando Gonzalez


Contract Number: H4006 Legal Entity Name: MCS ADVANTAGE INC.

Organization Marketing Name: MCS Classicare Parent Organization: Medical Card System, Inc.

Organization Type: Local CCP Contact Title: VP A- Medicare Compliance Plan Type: HMO/HMOPOS Name: Carlos J Fournier



Address: MCS Plaza Legal Entity Address: MCS PLAZA, SUITE 201 255 Ponce de Leon Avenue, Second Floor

255 PONCE DE LEON AVE. City: San Juan City: SAN JUAN State: PR


Contract Number: H4007 Legal Entity Name: HUMANA HEALTH PLANS OF PUERTO RICO INC

Organization Marketing Name: Humana Health Plans Of Puerto Rico Inc Parent Organization: Humana Inc.



383 F.D. Roosevelt Avenue, 3rd FloorLegal Entity Address: LouisvilleCity:

San Juan City: KYState: PRState: 40202Zip: 00918 Zip: 2/11/2009Last Updated:

Contract Number: H4008 Legal Entity Name: HUMANA INSURANCE OF PUERTO RICO, INC

Organization Marketing Name: Humana Insurance Of Puerto Rico, Inc Parent Organization: Humana Inc.



383 F.D. Roosevelt Avenue, 3rd FloorLegal Entity Address: LouisvilleCity:

San Juan City: KYState: PRState: 40202Zip: 00918 Zip: 2/11/2009Last Updated:

Contract Number: H4009 Legal Entity Name: SDM HEALTHCARE MANAGEMENT, INC.

Organization Marketing Name: Salud Dorada con Medicare Parent Organization: SDM Healthcare Management, Inc.


28 Calle Santa Cruz

Bayam≤n PR 00960

For Profit New York



City: State:

Zip:


Enrollment: 6,117


Director of Medicare Programs & Compliance

1-787-999-4797


Bayamon PR 00960-3078 4/7/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Hector L Feliciano


Contract Number: H4011 Legal Entity Name: FIRST MEDICAL HEALTH PLAN, INC.

Organization Marketing Name: First Medical Health Plan, Inc. Parent Organization: First Medical Health Plan

Organization Type: Local CCP Contact Title: Compliance Officer Plan Type: Local PPO Name: Alejandra Echevarria



Address: P.O. Box 195200 Legal Entity Address: PO BOX 195080

City: San Juan City: SAN JUAN State: PR



Organization Marketing Name: Triple-S Salud, Inc. Parent Organization: Triple-S Management Corporation

Organization Type: Local CCP Contact Title: Customer Service Manager Plan Type: HMO/HMOPOS Name: Armando Gonzalez



Address: 1441 Franklin D. Roosevelt Ave. Legal Entity Address: PO BOX 363628

1441 AVE ROOSEVELT City: San Juan City: SAN JUAN State: PR










Contract Number: H4102 Legal Entity Name: UNITEDHEALTHCARE OF NEW ENGLAND, INC.





Address: 5757 Plaza Dr Legal Entity Address: 3803 N ELM ST CA124-0142

City: Cyress City: GREENSBORO State: CA



Contract Number: H4105 Legal Entity Name: PACE ORGANIZATION OF RHODE ISLAND

Organization Marketing Name: Pace Organization Of Rhode Island Parent Organization: PACE Organization of Rhode Island

National PACE Organization Type: CEOContact Title: National PACE Plan Type: Name: Joan L Kwiatkowski 12/1/2005 Contract Effective Date: 1-401-490-6566 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: 1-401-490-6537 Fax:

Enrollment: 145 [email protected] Email: 225 Chapman Street, Box 7 Address:

225 CHAPMAN STREET Legal Entity Address: ProvidenceCity:

PROVIDENCE City: RIState: RIState: 02905Zip: 02905 Zip: 4/16/2009Last Updated:





475 KILVERT STREET Legal Entity Address: CA124-0142 SUITE 310 CyressCity: WARWICK City: CAState: RIState: 90630Zip: 028861392 Zip: 4/14/2009Last Updated:

Contract Number: H4125 Legal Entity Name: ARCADIAN HEALTH PLAN

Organization Marketing Name: Arcadian Health Plan Parent Organization: Arcadian Management Services Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Service 1/1/2008 Contract Effective Date: 1-800-573-8597 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 886 [email protected] Email: 825 Washington St. Suite 300 Address:

825 Washington Street., Suite 300 Legal Entity Address: OaklandCity:

OaklandCity: CAState: CAState: 94607Zip: 94607 Zip: 2/28/2008Last Updated:

Contract Number: H4142 Legal Entity Name: CHEROKEE NATION COMPREHENSIVE CARE AGENCY

Organization Marketing Name: Cherokee Elder Care Parent Organization: Cherokee Nation Comprehensive Care Agency


1387 W 4th St.

Tahlequah OK 74464

Not-for-Profit/Non-Profit Dallas



City: State:

Zip:


Enrollment: 24


Finance Director

1-918-207-4936

1-918-431-4112 [email protected] 1387 W 4th St.

Tahlequah OK 74464 3/6/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Thelma Pittman Name:


Contract Number: H4152 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND

Organization Marketing Name: Blue Cross & Blue Shield of Rhode Island Parent Organization: Blue Cross & Blue Shield of Rhode Island

Local CCP Organization Type: Customer Service Department Contact Title: HMO/HMOPOS Plan Type: Name: Cust. Service Department 1/1/1997 Contract Effective Date: 1-401-277-2958 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 39,751 [email protected] Email: 444 Westminster Street Address:

444 Westminster Street Legal Entity Address: ProvidenceCity:

PROVIDENCE City: RIState: RIState: 02903Zip: 02903 Zip: 6/25/2007Last Updated:

Contract Number: H4203 Legal Entity Name: PALMETTO HEALTH ALLIANCE

Organization Marketing Name: Palmetto SeniorCare Parent Organization: Palmetto Health Alliance

National PACE Organization Type: Administrative Coordinator Intake Contact Title: National PACE Plan Type: Name: Shirley Gregg 11/1/2003 Contract Effective Date: 1-803-931-8175 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-803-931-8164 Fax:

Enrollment: 342 [email protected] Email: 1308 Laureo Street Address:

15 RICHLAND MEDICAL PARK DRIVE Legal Entity Address: SUITE 203 ColumbiaCity: COLUMBIA City: SCState: SCState: 29201Zip: 29203 Zip: 8/21/2006Last Updated:

Contract Number: H4204 Legal Entity Name: INSTIL HEALTH INSURANCE COMPANY

Organization Marketing Name: InStil Health Insurance Company Parent Organization: BlueCross BlueShield of South Carolina (BCBSSC)

Organization Type: PFFS Contact Title: Manager, Contracts & Administration Plan Type: PFFS Name: Dee A Yurko



Address: P. O. Box 100294 Legal Entity Address: P.O. BOX 100294 Mail Code AG-790

AG-790 City: Columbia City: COLUMBIA State: SC

State: SC Zip: 29202 Zip: 292023294 Last Updated: 4/28/2009







City:State:

Zip:

H4205 BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA Blue Cross Blue Shield of South Carolina BlueCross BlueShield of South Carolina (BCBSSC) PFFS Contact Title: PFFS Name: 6/1/2005 Phone: For Profit Extension: Atlanta Fax: 4,832 Email:

Address: 2501 Faraway Drive

City: COLUMBIA State: SC Zip: 29223 Last Updated:

Manager - Enrollment and Billing Keyla Clark 1-803-264-1440

1-803-264-9581 [email protected] 4101 Percival Road AX-G07 Columbia SC 29229 12/26/2008


Contract Number: H4209 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA

Organization Marketing Name: Blue Cross Blue Shield of South Carolina Parent Organization: BlueCross BlueShield of South Carolina (BCBSSC)

Organization Type: Local CCP Contact Title: Manager - Enrollment and Billing Plan Type: Local PPO Name: Keyla Clark



Address: 4101 Percival Road Legal Entity Address: 2501 Faraway Drive AX-G07

City: Columbia City: COLUMBIA State: SC


Contract Number: H4270 Legal Entity Name: UCARE WISCONSIN, INC.


Organization Type: Local CCP Contact Title: Medicare Customer Services Supervisor Plan Type: HMO/HMOPOS Name: Vatisha Hammick



Address: PO Box 52 Legal Entity Address: 500 Stinson Boulevard NE

City: Minneapolis City: Minneapolis State: MN


Contract Number: H4305 Legal Entity Name: TOTAL LIFE HEALTHCARE

Organization Marketing Name: Total Life Healthcare Parent Organization: St. Bernard's Healthcare

Organization Type: National PACE Contact Title: Finance Manager Plan Type: National PACE Name: Terry Combs



Address: 225 East Jackson #92 Legal Entity Address: 225 East Jackson #92

City: Jonesboro City: Jonesboro State: AR

State: AR Zip: 72401 Zip: 72401 Last Updated: 4/30/2008






Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington avenue




Contract Number: H4402 Legal Entity Name: ALEXIAN BROTHERS COMMUNITY SERVICES

Organization Marketing Name: Alexian Brothers Community Services Parent Organization: Alexian Brothers Community Services

National PACE Organization Type: ITContact Title: National PACE Plan Type: Name: Jon Gabert 11/1/2002 Contract Effective Date: 1-423-698-0802 Phone: Not-for-Profit/Non-Profit Tax Status: 212Extension: Atlanta CMS Region Responsible: 1-423-622-6048 Fax:

Enrollment: 301 [email protected] Email: 425 Cumberland Street Address:

425 CUMBERLAND STREET Legal Entity Address: Suite 110 Suite 110 Chattanooga City: CHATTANOOGA City: TNState: TNState: 37404Zip: 37404 Zip: 4/1/2008Last Updated:

Contract Number: H4406 Legal Entity Name: UNITEDHEALTHCARE OF TENNESSEE, INC.




9900 BREN ROAD EAST Legal Entity Address: CA124-0142 MAIL ROUTE MN008-W140 CyressCity: MINNETONKA City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:


Organization Marketing Name: Healthspring, Inc. Parent Organization: HealthSpring, Inc.

Organization Type: Local CCP Contact Title: Vice President of Customer Service Plan Type: HMO/HMOPOS Name: Wendy Wetzel



Address: 2900 North Loop West Legal Entity Address: 44 VANTAGE WAY Suite 1300

SUITE 300 City: Houston City: NASHVILLE State: TX











Contract Number: H4449 Legal Entity Name: SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.


Organization Type: PFFS Contact Title: Network Contract Coordinator Plan Type: PFFS Name: David Gardineer



Address: P.O. Box 15645 Legal Entity Address: 2720 N. Tenaya Way

City: Las Vegas City: Las Vagas State: NV



Organization Marketing Name: Healthspring Parent Organization: HealthSpring, Inc.

Local CCP Organization Type: Vice President of Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Wendy Wetzel 10/1/1996 Contract Effective Date: 1-832-553-3300 Phone: For Profit Tax Status: 3379Extension: Denver CMS Region Responsible: Fax:

Enrollment: 55,628 [email protected] Email: 2900 North Loop West Address:

44 VANTAGE WAY, SUITE 300 Legal Entity Address: Suite 1300 HoustonCity:

NASHVILLE City: TXState: TNState: 77092Zip: 37228 Zip: 2/5/2009Last Updated:

Contract Number: H4456 Legal Entity Name: UNITEDHEALTHCARE OF THE RIVER VALLEY, INC.



1300 River Drive, Suite 200

Moline IL 61265




City: State:

Zip:


Enrollment: 37,871


CARITEN HEALTH PLAN IN H4461


Humana Health Plan, Inc. Organization Marketing Name: Humana Inc.Parent Organization: Local CCP HMO/HMOPOS 1/1/1998

500 West Main St

Louisville KY 40202




City: State:

Zip:


Enrollment: 48,614


1-888-867-5517


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Richard IrwinName:

1-800-457-4708



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:




Legal Entity Name: SELECTCARE OF TEXAS, L.L.C.Organization Marketing Name: Universal American

Parent Organization: Universal American Corp.Organization Type: Local CCP Contact Title: Member Service Representative

Plan Type: HMO/HMOPOS Name: Member Services Contract Effective Date: 3/1/2001 Phone: 1-866-230-2513

Tax Status: For Profit Extension: CMS Region Responsible: Dallas Fax:

Enrollment: 44,172 Email: [email protected] Address: 4888 Loop Central Drive

Legal Entity Address: 4888 Loop Central Drive Suite 900 Suite 300 City: Houston

City: Houston State: TX State: TX Zip: 77081

Zip: 77081 Last Updated: 12/9/2008 Contract Number: H4510 Legal Entity Name: HUMANA HEALTH PLAN OF TEXAS,INC.

Organization Marketing Name: Humana Health Plan of Texas, Inc. Parent Organization: Humana Inc.



1221 South Mopac, Suite 200 Legal Entity Address: LouisvilleCity:

AustinCity: KYState: TXState: 40202Zip: 78746 Zip: 8/22/2006Last Updated:

Contract Number: H4513 Legal Entity Name: TEXAS HEALTHSPRING LLC

Organization Marketing Name: Texas HealthSpring Parent Organization: HealthSpring, Inc.




Address: 2900 North Loop West Suite 1300 Legal Entity Address: 2900 N LOOP WEST, SUITE 1300

City: Houston City: HOUSTON State: TX


Contract Number: H4514 Legal Entity Name: EVERCARE OF TEXAS, LLC






MN 008-W130 City: Cyress City: MINNETONKA State: CA



Contract Number: H4517 Legal Entity Name: AMARILLO MULTISVC CTR FR THE AGING INC

Organization Marketing Name: Amarillo Multisvc Ctr For The Aging Inc Parent Organization: Amarillo Multisvc Ctr Fr the Aging Inc

National PACE Organization Type: Contact Title: National PACE Plan Type: Name: Alana Chilcote 3/1/2004 Contract Effective Date: 1-806-374-5516 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-806-373-9446 Fax:

Enrollment: 131 [email protected] Email: 3108 S Fillmore Address:

3108 SOUTH FILLMORE STREET Legal Entity Address: Amarillo City:

AMARILLO City: TXState: TXState: 79110Zip: 79110 Zip: 5/20/2008Last Updated:

Contract Number: H4518 Legal Entity Name: BIENVIVIR SENIOR HEALTH SERVICES

Organization Marketing Name: Bienvivir Senior Health Services Parent Organization: Bienvivir Senior Health Services

National PACE Organization Type: Chief Operations Officer Contact Title: National PACE Plan Type: Name: Margie Murphy 11/1/2003 Contract Effective Date: 1-915-562-3444 Phone: Not-for-Profit/Non-Profit Tax Status: 2290Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 699 [email protected] Email: 2300 McKinley Address:

2300 McKinley Legal Entity Address: El PasoCity:

EL PASO City: TXState: TXState: 79930Zip: 79930 Zip: 9/13/2006Last Updated:







Contract Number: H4521 Legal Entity Name: TEXAS HEALTH SPRING LLC

Organization Marketing Name: Texas HealthSpring Parent Organization: HealthSpring, Inc.



CMS Region Responsible: Denver Fax: 1-832-553-3400 Enrollment: 412 Email: [email protected]

Address: 2900 North Loop West Suite 1300 Legal Entity Address: 2900 N LOOP WEST, SUITE 1300

City: Houston City: HOUSTON State: TX







9900 Bren Road East Legal Entity Address: CA124-0142 CyressCity:






2777 Stemmons Freeway Suite 400 Legal Entity Address: Hartford City:

Dallas City: CTState: TXState: 06156Zip: 753569440 Zip: 8/23/2006Last Updated:







Contract Number: H4525 Legal Entity Name: SHA, L.L.C

Organization Marketing Name: FirstCare Advantage Parent Organization: Covenant Health System - Hendrick Health System


12940 North Highway 183

Austin TX 78750

For Profit Dallas



City: State:

Zip:


Enrollment: 1,996


Customer Service

1-866-229-4969

1-806-784-4190 [email protected] 1901 West Loop 289, Suite 9

Lubbock TX 79407 5/26/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H4527 Legal Entity Name: PSO HEALTH SERVICES, LLC

Organization Marketing Name: PHYSICIANS HEALTH CHOICE Parent Organization: PSO Health Services, LLC

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 8/1/2005 Contract Effective Date: 1-866-550-4736 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 16,899 [email protected] Email: 5800 Northwest Parkway Suite 125 Address:

8637 FREDERICKSBURG ROAD, SUITE 360 Legal Entity Address: San Antonio City:

SAN ANTONIO City: TXState: TXState: 78249Zip: 78240 Zip: 8/18/2008Last Updated:

Contract Number: H4528 Legal Entity Name: BRAVO HEALTH TEXAS, INC.





Address: 3601 O'Donnell Street Legal Entity Address: 11765 WEST AVENUE

City: Baltimore City: SAN ANTONIO State: MD


Contract Number: H4529 Legal Entity Name: ARCADIAN HEALTH PLAN, INC.

Organization Marketing Name: Texas Community Care Parent Organization: Arcadian Management Services Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Member Service



Address: 825 Washington St. Suite 300 Legal Entity Address: 825 WASHINGTON STREET, SUITE 300

City: Oakland City: OAKLAND State: CA



Organization Marketing Name: HISC - Blue Cross Blue Shield of Texas Parent Organization: Health Care Service Corporation




Address: P.O. Box 3567 Legal Entity Address: 901 South Central Expressway, North Building

City: Scranton City: Richardson State: PA



Contract Number: H4556 Legal Entity Name: CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC

Organization Marketing Name: Consolidated Assoc Of Railroad Employees Hc Parent Organization: Consolidated Assoc of Railroad Employees HC

HCPP - 1833 Cost Organization Type: No contact data submitted Contact Title: HCPP - 1833 Cost Plan Type: Name: 1/1/1992 Contract Effective Date: Phone:

Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 5,011 Email: Address:

4912 MIDWAY DR. Legal Entity Address: P.O. BOX 6130 City: TEMPLE City: State: TXState: Zip: 76502 Zip: Last Updated:

Contract Number: H4564 Legal Entity Name: SCOTT AND WHITE HEALTH PLAN

Organization Marketing Name: Scott and White Health Plan SeniorCare Parent Organization: Scott and White

1876 Cost Organization Type: Call Center Contact Title: 1876 Cost Plan Type: Name: Customer Service 4/1/1996 Contract Effective Date: 1-866-344-3141 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 23,575 [email protected] Email: 2401 South 31st Street Address:

2401 SOUTH 31ST STREET Legal Entity Address: TempleCity:

TEMPLE City: TXState: TXState: 76508Zip: 76508 Zip: 8/21/2006Last Updated:

Contract Number: H4577 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ILLINOIS, INC.


Organization Type: PFFS Contact Title: Plan Directory Contact Plan Type: PFFS Name: Mary Solomon



Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 2

City: Tampa City: Tampa State: FL


Contract Number: H4590 Legal Entity Name: PACIFICARE OF TEXAS, INC.





Address: 5757 Plaza Dr Legal Entity Address: 8200 IH-10 CA124-0142

SUITE 1000 City: Cyress City: SAN ANTONIO State: CA



Contract Number: H4604 Legal Entity Name: UNITEDHEALTHCARE OF UTAH, INC.




2795 EAST COTTONWOOD PARKWAY #200 Legal Entity Address: CA124-0142 CyressCity:

SALT LAKE CITY City: CAState: UTState: 90630Zip: 84121 Zip: 4/14/2009Last Updated:

Contract Number: H4605 Legal Entity Name: REGENCE BLUECROSS BLUESHIELD OF UT

Organization Marketing Name: Regence BlueCross BlueShield of Utah Parent Organization: The Regence Group



P.O. Box 12625 Legal Entity Address: 201 High Street SE SeattleCity: Salem City: WAState: ORState: 98101-1322 Zip: 97309 Zip: 12/15/2008Last Updated:







Contract Number: H4652 Legal Entity Name: UNION PACIFIC RR EMPLOYES HEALTH SYS

Organization Marketing Name: Union Pacific Railroad Employes Health Systems Parent Organization: Union Pacific Railroad Employees Health Systems

HCPP - 1833 Cost HCPP - 1833 Cost 12/1/1993

1040 N 2200 W Suite 200

Salt Lake City UT 84116




City: State:

Zip:


Enrollment: 11,623


Manager of Customer Services

1-801-595-4309

1-801-595-2009 [email protected] 1040 N 2200 W Suite 200

Salt Lake City UT 84116 8/25/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Deeann Benson


Contract Number: H4720 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK

Organization Marketing Name: SecureHorizons MedicareDirect Parent Organization: UnitedHealth Group, Inc.

PFFS Organization Type: Contact Title: PFFS Plan Type: Richard IrwinName: 1/1/2007 Contract Effective Date: 1-888-867-5517 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:


C/O Ovations, SRS, 9900 Bren Road East, MN008-T44 Legal Entity Address: CA124-0142 CyressCity:






9900 Bren Rd E Legal Entity Address: CA124-0142 MN008-T440 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:







Contract Number: H4836 Legal Entity Name: MEDICAL MUTUAL OF OHIO

Organization Marketing Name: Advantage Plan from Medical Mutual of Ohio Parent Organization: MEDICAL MUTUAL OF OHIO

PFFS PFFS 1/1/2008

2060 East 9th Street

Cleveland OH 44115

For Profit Chicago



City: State:

Zip:


Enrollment: 1,447


Manager, Performance Group Call Center

1-800-982-3117

[email protected] 2060 East Ninth Street

Cleveland OH 44115 2/27/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Nancy Peebles


Contract Number: H4837 Legal Entity Name: UNITEDHEALTHCARE OF WISCONSIN

Organization Marketing Name: UnitedHealthcare Personal Care Plus Parent Organization: UnitedHealth Group, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Veronica Britt 1/1/2008 Contract Effective Date: 1-414-443-4072 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 14 [email protected] Email: 10701 W. Research Dr Address:

10701 W. Research Drive Legal Entity Address: P.O. Box 26649 MilwaukeeCity: Wauwatosa City: WIState: WIState: 53226Zip: 53226 Zip: 5/30/2008Last Updated:

Contract Number: H4906 Legal Entity Name: C AND O EMPLOYEES' HOSPITAL ASSOCIATION

Organization Marketing Name: C and O Employees' Hospital Association Parent Organization: C & O Employees' Hospital Association

HCPP - 1833 Cost Organization Type: Dues ClerkContact Title: HCPP - 1833 Cost Plan Type: Name: Margaret Brown 5/1/1999 Contract Effective Date: 1-800-679-9135 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-540-862-4958 Fax:

Enrollment: 2,850 [email protected] Email: 511 Main Street, 2nd Floor Address:

511 MAIN STREET, 2ND FLOOR Legal Entity Address: Clifton Forge City:

CLIFTON FORGE City: VAState: VAState: 24422Zip: 24422 Zip: 9/28/2007Last Updated:

Contract Number: H4908 Legal Entity Name: OPTIMA HEALTH INSURANCE COMPANY

Organization Marketing Name: Optima Medicare Parent Organization: Sentara Healthcare

Organization Type: Local CCP Contact Title: Director, Customer Service Plan Type: Local PPO Name: Ydsia N Slagle



Address: 4417 Corporation Lane Legal Entity Address: 4417 CORPORATION LANE

City: Virginia Beach City: VIRGINIA BEACH State: VA

State: VA Zip: 23462 Zip: 23462 Last Updated: 8/23/2006

Contract Number: H4909 Legal Entity Name: ANTHEM HEALTH PLANS OF VIRGINIA, INC.










Legal Entity Name: AETNA HEALTH INC.Organization Marketing Name: Aetna Medicare

Parent Organization: Aetna Inc.Organization Type: Local CCP Contact Title:

Plan Type: HMO/HMOPOS Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: 1-800-445-1796

Tax Status: For Profit Extension: CMS Region Responsible: Boston Fax:

Enrollment: 300 Email: [email protected] Address: 151 Farmington Avenue

Legal Entity Address: 1302 Concourse Drive City: Hartford

City: Linthicum State: CT State: MD Zip: 06156

Zip: 21090 Last Updated: 8/23/2006 Contract Number: H4911 Legal Entity Name: AETNA LIFE INSURANCE COMPANY




151 FARMINGTON AVENUE Legal Entity Address: Hartford City:


Contract Number: H4917 Legal Entity Name: GUARDIAN HEALTHCARE,INC.

Organization Marketing Name: Guardian Healthcare, Inc. Parent Organization: Guardian Healthcare, Inc.

Organization Type: PFFS Contact Title: COO and Compliance Officer Plan Type: PFFS Name: Richard E Cairl



Address: 33 Market Point Drive Legal Entity Address: 33 Market Point Drive

City: Greenville City: Greenville State: SC
















Contract Number: H4979 Legal Entity Name: BLUECROSS BLUESHIELD OF TENNESSEE

Organization Marketing Name: BlueCross BlueShield of Tennessee Parent Organization: BlueCross BlueShield of Tennessee

PFFS Organization Type: Supervisor Medicare Advantage Operations Contact Title: PFFS Plan Type: Name: Carol Troxell 1/1/2009 Contract Effective Date: 1-800-841-7434 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 1,805 [email protected] Email: 801 Pine Street Address:

801 Pine Street Legal Entity Address: Chattanooga City:

Chattanooga City: TNState: TNState: 37402Zip: 37402 Zip: 12/27/2007Last Updated:

Contract Number: H5005 Legal Entity Name: PACIFICARE OF WASHINGTON, INC.




7525 S.E. 24TH STREET Legal Entity Address: CA124-0142 CyressCity:

MERCER ISLAND City: CAState: WAState: 90630Zip: 98040 Zip: 4/14/2009Last Updated:

Contract Number: H5006 Legal Entity Name: STERLING LIFE INSURANCE COMPANY

Organization Marketing Name: Sterling Life Insurance Company Parent Organization: Munich American Holding Corporation

PFFS PFFS 7/1/2000

2219 Rimland Drive P.O. BOX 5348 BELLINGHAM WA 982275348

For Profit Seattle



City: State:

Zip:


Enrollment: 93,668



1-360-647-9080 29073

[email protected] 2219 Rimland Drive PO Box 5348 Bellingham WA 98227-5348 7/25/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendi Western


Contract Number: H5007 Legal Entity Name: PROVIDENCE HEALTH SYSTEM

Organization Marketing Name: Providence Health System Parent Organization: Providence Health System

National PACE Organization Type: Compliance & Special Projects Coordinator Contact Title: National PACE Plan Type: Susan Hayashida Name: 11/1/2002 Contract Effective Date: 1-206-320-5325 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-206-760-6339 Fax:

Enrollment: 303 [email protected] Email: 4515 Martin Luther King Jr. Way S. Ste. 100 Address:

4515 MARTIN LUTHER KING JR.WAY SOUTH STE 10 Legal Entity Address: SeattleCity:

SEATTLE City: WAState: WAState: 98108Zip: 98108 Zip: 5/24/2007Last Updated:







Contract Number: H5009 Legal Entity Name: REGENCE BLUESHIELD

Organization Marketing Name: Regence BlueShield Parent Organization: The Regence Group



P. O. Box 12625 Legal Entity Address: 201 High Street SE SeattleCity: Salem City: WAState: ORState: 98101-1322 Zip: 97309 Zip: 12/15/2008Last Updated:

Contract Number: H5010 Legal Entity Name: ASURIS NORTHWEST HEALTH

Organization Marketing Name: Asuris Northwest Health Parent Organization: The Regence Group


P.O. Box 12625 201 High Street SE Salem OR 97309




City: State:

Zip:


Enrollment: 1,451


Supr Ind Mktg

1-888-734-3623

[email protected] 1800 Ninth Ave

Seattle WA 98101-1322 12/15/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Shane Shown


Contract Number: H5031 Legal Entity Name: DAVITA VILLAGEHEALTH OF DC, INC.

Organization Marketing Name: DaVita VillageHealth of DC, Inc. Parent Organization: Davita Inc

Local CCP Organization Type: Sr Manager, Marketing Operations and Communication Contact Title: Local PPO Plan Type: Name: Teri Hunt 1/1/2008 Contract Effective Date: 1-303-626-6247 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: 1-303-626-6384 Fax:

Enrollment: 22 [email protected] Email: 1627 Cole Blvd Address:

Three Hawthorn Parkway Legal Entity Address: Suite 410 Lakewood City: Vernon HillsCity: COState: ILState: 80401Zip: 60061 Zip: 1/14/2008Last Updated:

Contract Number: H5037 Legal Entity Name: MOUNTAIN EMPIRE OLDER CITIZENS, INCX.

Organization Marketing Name: Mountain Empire PACE Parent Organization: Mountain Empire Older Citizens, Inc

National PACE Organization Type: Contact Title: National PACE Plan Type: Name: Tony Lawson 3/1/2008 Contract Effective Date: 1-276-523-0599 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-276-523-4690 Fax:

Enrollment: 43 [email protected] Email: P. O. Box 888 Address:

1501 Third Avenue East Legal Entity Address: P.O. Box 888 Big Stone Gap City: Big Stone Gap City: VAState: VAState: 24219Zip: 24219 Zip: 4/23/2009Last Updated:







Contract Number: H5042 Legal Entity Name: CDPHP UNIVERSAL BENEFITS, INC.

Organization Marketing Name: CDPHP Medicare Choices Parent Organization: Capital District Physicians' Health Plan, Inc.


500 Patroon Creek Blvd.

Albany NY 12206




City: State:

Zip:


Enrollment: 2,347


Manager, Member Services

1-518-641-3710

[email protected] 500 Patroon Creek Blvd

Albany NY 12206 2/1/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Laura Kordas


Contract Number: H5050 Legal Entity Name: GROUP HEALTH COOPERATIVE

Organization Marketing Name: Group Health Cooperative Parent Organization: Group Health Cooperative

Organization Type: Local CCP Contact Title: Health Plan Operations Plan Type: HMO/HMOPOS Name: Provider Assistance Unit



Address: Group Health Cooperative, Provider Assistance Unit Legal Entity Address: 320 Westlake Avenue North, Suite 100 PO Box 34585

Attn: Medicare Programs & Compliance City: Seattle City: SEATTLE State: WA

State: WA Zip: 98124-1585 Zip: 981095233 Last Updated: 6/2/2008

Contract Number: H5087 Legal Entity Name: EASY CHOICE HEALTH PLAN INC.

Organization Marketing Name: Easy Choice Health Plan Parent Organization: Easy Choice Health Plan Inc.

Local CCP Organization Type: Enrollment and Customer Service Department Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2008 Contract Effective Date: 1-866-999-3945 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-877-999-3945 Fax:

Enrollment: 3,259 [email protected] Email: 20411 S.W. Birch Street Address:

20411 S.W. Birch StreetLegal Entity Address: Suite 200 Suite 200 Newport BeachCity: Newport Beach City: CAState: CAState: 92660Zip: 92660 Zip: 8/25/2008Last Updated:

Contract Number: H5106 Legal Entity Name: HIGHMARK HEALTH INSURANCE COMPANY

Organization Marketing Name: Highmark Health Insurance Company Parent Organization: Highmark Inc.

Organization Type: Local CCP Contact Title: VP, Sr. Products Operations Plan Type: Local PPO Name: Sally Rich



Address: 120 Fifth Avenue Legal Entity Address: 120 Fifth Avenue P5501


State: PA Zip: 15222-3099 Zip: 15222 Last Updated: 2/28/2007










Contract Number: H5151 Legal Entity Name: HEALTH PLAN OF THE UPPER OHIO VALLEY

Organization Marketing Name: The Health Plan Parent Organization: Health Plan of the Upper Ohio Valley

Local CCP Organization Type: Director Member Services Contact Title: HMO/HMOPOS Plan Type: Name: Sherry Stanley 2/1/1999 Contract Effective Date: 1-740-695-7682 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-740-695-8103 Fax:

Enrollment: 9,833 [email protected] Email: The Health Plan Address:

52160 NATIONAL ROAD EAST Legal Entity Address: 52160 National Road East St. ClairsvilleCity:

ST. CLAIRSVILLE City: OHState: OHState: 43950Zip: 43950 Zip: 8/23/2006Last Updated:

Contract Number: H5167 Legal Entity Name: ROCKY MOUNTAIN HEALTH CARE SERVICES

Organization Marketing Name: Rocky Mountain PACE Parent Organization: Rocky Mountain Health Care Services

Organization Type: National PACE Contact Title: PACE Site Director Plan Type: National PACE Name: Kris Abbott



Address: 2335 Robinson Street Legal Entity Address: 2335 Robinson Street

City: Colorado Springs City: Colorado Springs State: CO


Contract Number: H5179 Legal Entity Name: CIGNA HEALTHCARE OF ARIZONA, INC.

Organization Marketing Name: CIGNA Medicare Access Parent Organization: CIGNA

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Medicare Team



Address: Medicare Team Legal Entity Address: 11001 N. Black Canyon Highway P.O. Box 42005

City: Phoenix City: Phoenix State: AZ

State: AZ Zip: 85080 Zip: 85029 Last Updated: 2/23/2007






Address: Unison Plaza Legal Entity Address: 890 Willow Tree Circle 1001 Brinton Road

Suite 10 City: Pittsburgh City: Cordova State: PA



Contract Number: H5206 Legal Entity Name: PARTNERSHIP HEALTH PLAN, INC.

Organization Marketing Name: Community Health Partnership Parent Organization: Community Health Partnership, Inc.

Local CCP Organization Type: Claims Specialist Contact Title: HMO/HMOPOS Plan Type: Name: Priscilla Koxlien 1/1/1999 Contract Effective Date: 1-715-838-2916 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-715-838-2910 Fax:

Enrollment: 1,655 [email protected] Email: 2240 EastRidge Center Address:

2240 EASTRIDGE CENTER Legal Entity Address: Eau Claire City:

EAU CLAIRE City: WIState: WIState: 54701Zip: 54701 Zip: 5/19/2008Last Updated:

Contract Number: H5207 Legal Entity Name: COMMUNITY CARE HEALTH PLAN, INC


Organization Type: Local CCP Contact Title: Marketing Manager Plan Type: HMO/HMOPOS Name: Julie Erdmann



Address: 1555 S. Layton Blvd. Legal Entity Address: 1555 S. Layton Blvd.



Contract Number: H5209 Legal Entity Name: CARE WISCONSIN HEALTH PLAN, INC.

Organization Marketing Name: Care Wisconsin Health Plan, Inc. Parent Organization: Care Wisconsin First, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/1999 Contract Effective Date: 1-800-963-0035 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 862 [email protected] Email: 2802 International Lane Address:

2802 INTERNATIONAL LANE Legal Entity Address: P.O. Box 14017 PO BOX 14017 Madison City: MADISON City: WIState: WIState: 53708-0017 Zip: 537080017 Zip: 4/30/2009Last Updated:

Contract Number: H5211 Legal Entity Name: SECURITY HEALTH PLAN OF WISCONSIN, INC

Organization Marketing Name: Security Health Plan Of Wisconsin, Inc Parent Organization: Marshfield Clinic.


1515 SAINT JOSEPH AVENUE PO Box 8000 MARSHFIELD WI 54449




City: State:

Zip:


Enrollment: 22,005



1-897-998-0998

1-715-221-9500 [email protected] 1515 Saint Joseph Avenue PO Box 8000 Marshfield WI 54449-8000 5/19/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Ken Baur


Contract Number: H5212 Legal Entity Name: COMMUNITY CARE, INC.


Organization Type: National PACE Contact Title: Marketing Manager Plan Type: National PACE Name: Julie Erdmann



Address: 1555 S. Layton Blvd. Legal Entity Address: 1555 S. Layton Blvd.



Contract Number: H5213 Legal Entity Name: TOTAL COMMUNITY CARE, L.L.C.

Organization Marketing Name: Total Community Care Parent Organization: Total Community Care,LLC

Organization Type: National PACE Contact Title: AVP Medicare and Medicaid Compliance Plan Type: National PACE Name: Matthew Zimmerman



Address: 200 E. 9th Ave. Legal Entity Address: 904 A LAS LOMAS N.E.

City: Denver City: Albuquerque State: CO








Contract Number: H5215 Legal Entity Name: NETWORK HEALTH INSURANCE CORPORATION

Organization Marketing Name: Network Health Insurance Corp. MA Plans Parent Organization: Affinity Health System


1570 MIDWAY PLACE P.O. Box 120 MENASHA WI 54952

For Profit Chicago



City: State:

Zip:


Enrollment: 19,910


VP Medicare Products

1-920-720-1556

1-920-720-1912 [email protected] 1570 Midway Place P.O. Box 120 Menasha WI 54952 3/24/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Marcia Broeren








Contract Number: H5227 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE COMPANY


Organization Type: PFFS Contact Title: Customer Service Plan Type: PFFS Name: Advantra Freedom



Address: Advantra Freedom/Coventry Health Care, Inc Legal Entity Address: 6705 Rockledge Drive Suite 900 PO Box 7154

City: London City: Bethesda State: KY


Contract Number: H5253 Legal Entity Name: UNITEDHEALTHCARE OF WISCONSIN, INC




10701 W. RESEARCH DRIVE Legal Entity Address: CA124-0142 P.O. BOX 26649 CyressCity: MILWAUKEE City: CAState: WIState: 90630Zip: 532260649 Zip: 4/14/2009Last Updated:

Contract Number: H5256 Legal Entity Name: MEDICAL ASSOCIATES CLINIC HEALTH PLAN

Organization Marketing Name: Medical Associates Clinic Health Plan of Wisconsin Parent Organization: Medical Associates Clinic

Organization Type: 1876 Cost Contact Title: Marketing Specialist Plan Type: 1876 Cost Name: Julie Hoffmann


CMS Region Responsible: Kansas City Fax: 1-563-556-5134 Enrollment: 2,565 Email: [email protected]

Address: 1605 Associates Drive, Suite 101 Legal Entity Address: 1605 ASSOCIATES DRIVE, Suite 101

City: Dubuque City: DUBUQUE State: IA



Contract Number: H5262 Legal Entity Name: GUNDERSEN LUTHERAN HEALTH PLAN

Organization Marketing Name: Gundersen Lutheran Health Plan, Inc. Parent Organization: Gunderson Lutheran, Inc.




Address: 1900 South Avenue Legal Entity Address: 3190 Gundersen Drive Mailstop: NCA2-01

City: La Crosse City: Onalaska State: WI


Contract Number: H5264 Legal Entity Name: DEAN HEALTH PLAN, INC.

Organization Marketing Name: Dean Health Plan, Inc. Parent Organization: Dean Health Systems Inc.

Organization Type: 1876 Cost Contact Title: Plan Type: 1876 Cost Name: Mike Fox



Address: 1277 Deming Way Legal Entity Address: 1277 DEMING WAY

City: Madison City: MADISON State: WI


Contract Number: H5270 Legal Entity Name: PAN AMERICAN LIFE INSURANCE COMPANY OF PUERTO RICO

Organization Marketing Name: PALIC Medicare Parent Organization: Pan American Life Insurance Company

Organization Type: Local CCP Contact Title: Project Manager Plan Type: HMO/HMOPOS Name: Janice Albert



Address: PO BOX 364865 Legal Entity Address: Metro Office Park 2 Calle 1 Suite 101

Calle 1 Suite 101 City: San Juan City: Guaynabo State: PR







Address: 101 East Main Street Legal Entity Address: 201 West Main Street




Contract Number: H5294 Legal Entity Name: SUPERIOR HEALTH PLAN, INC.

Organization Marketing Name: Advantage by SuperiorHealthPlan Parent Organization: Centene Corporation

Local CCP Organization Type: COOContact Title: HMO/HMOPOS Plan Type: Name: Holly Munin 1/1/2008 Contract Effective Date: 1-512-692-1465 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 117 [email protected] Email: 2100 South IH - 35, Address:

The Regency Building, Suite 202 Legal Entity Address: Suite 202 2100 South IH-35 AustinCity: AustinCity: TXState: TXState: 78704Zip: 78704 Zip: 8/15/2007Last Updated:

Contract Number: H5301 Legal Entity Name: PENNSYLVANIA LIFE INSURANCE COMPANY


Demo Organization Type: Member Service Representative Contact Title: ESRD I - PFFS Plan Type: Name: Member Services 1/1/2007 Contract Effective Date: 1-866-230-2513 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 182 [email protected] Email: 4888 Loop Central Drive Address:

c/o HHS Texas Management Legal Entity Address: Suite 900 4888 Loop Central Drive, Suite 800 HoustonCity: Houston City: TXState: TXState: 77081Zip: 77081 Zip: 12/9/2008Last Updated:

Contract Number: H5302 Legal Entity Name: COVENTRY HEALTH CARE OF GEORGIA, INC.

Organization Marketing Name: Advantra Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Customer Service Plan Type: HMO/HMOPOS Name: Advantra Freedom



Address: 3721 TecPort Dr, PO 67103 Legal Entity Address: 1100 Circle 75 Parkway Suite 1400

City: Harrisburg City: Atlanta State: PA

State: GA Zip: 17106-7103 Zip: 30339 Last Updated: 8/24/2006

Contract Number: H5304 Legal Entity Name: EMPIRE HEALTHCHOICE ASSURANCE, INC.

Organization Marketing Name: Empire BlueCross BlueShield Parent Organization: Wellpoint, Inc.








Contract Number: H5324 Legal Entity Name: HALE MAKUA

Organization Marketing Name: Maui PACE Parent Organization: HALE MAKUA

National PACE Organization Type: DirectorContact Title: National PACE Plan Type: Connie MillerName: 10/1/2008 Contract Effective Date: 1-808-442-4552 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-808-442-4560 Fax:

Enrollment: 10 [email protected] Email: 472 Kaulana Street Address:

472 Kaulana Street Legal Entity Address: KahuluiCity:

Kahului, Maui City: HIState: HIState: 96732Zip: 96732 Zip: 9/8/2008Last Updated:









Contract Number: H5402 Legal Entity Name: QUALITY HEALTH PLANS, INC.

Organization Marketing Name: Quality Health Plans Parent Organization: Quality Health Plans, Inc.

Organization Type: Local CCP Contact Title: Director of Compliance Plan Type: HMO/HMOPOS Name: Angela Hart



Address: 4010 Gunn Highway Suite 220 Legal Entity Address: 2435 US HIGHWAY 19

SUITE 470 City: Tampa City: HOLIDAY State: FL


Contract Number: H5403 Legal Entity Name: ON LOK SENIOR HEALTH SERVICES

Organization Marketing Name: On Lok Lifeways Parent Organization: On Lok Senior Health Services


1333 BUSH STREET

SAN FRANCISCO CA 94109




City: State:

Zip:


Enrollment: 979


Information and Referral Specialist

1-888-996-6565

1-415-292-8745 [email protected] 1333 Bush St.

San Francisco CA 94109 8/18/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Norine Bell


Contract Number: H5404 Legal Entity Name: UNIVERSAL HEALTH CARE, INC.

Organization Marketing Name: Universal Health Care, Inc. Parent Organization: Universal Health Care Inc.

Organization Type: Local CCP Contact Title: COMPLIANCE OFFICER Plan Type: HMO/HMOPOS Name: BRUCE R HOFFMAN



Address: UNIVERSAL HEALTH CARE, INC. Legal Entity Address: 100 Central Avenue 100 CENTRAL AVENUE , SUITE 200

Suite #200 City: SAINT PETERSBURG City: Saint Petersburg State: FL


Contract Number: H5405 Legal Entity Name: CENTER FOR ELDERS INDEPENDENCE

Organization Marketing Name: Center For Elders Independence Parent Organization: Center For Elders Independence

National PACE Organization Type: IT Manager Contact Title: National PACE Plan Type: David S VirgoName: 11/1/2003 Contract Effective Date: 1-510-433-1160 Phone: Not-for-Profit/Non-Profit Tax Status: 8044Extension: San Francisco CMS Region Responsible: 1-510-452-8836 Fax:

Enrollment: 374 [email protected] Email: 510-17th St., Suite 400 Address:

510-17th St., Suite 400 Legal Entity Address: OaklandCity:


Contract Number: H5406 Legal Entity Name: SUTTER HEALTH SACRAMENTO SIERRA REGION

Organization Marketing Name: Sutter SeniorCare Parent Organization: Sutter Health Sacramento Sierra Region

National PACE Organization Type: DirectorContact Title: National PACE Plan Type: Name: William Clearwater 11/1/2003 Contract Effective Date: 1-916-424-8412 Phone: Not-for-Profit/Non-Profit Tax Status: 13404Extension: San Francisco CMS Region Responsible: 1-916-491-3484 Fax:

Enrollment: 197 [email protected] Email: 7000 Franklin Blvd., Suite 1020 Address:

7000 Franklin Blvd., Suite 1020 Legal Entity Address: Sacramento City:

Sacramento City: CAState: CAState: 95823Zip: 95823 Zip: 10/1/2008Last Updated:

Contract Number: H5407 Legal Entity Name: CITRUS HEALTH CARE, INC.

Organization Marketing Name: Citrus Health Care, Inc. Parent Organization: Citrus Health Care, Inc.


5420 BAY CENTER DRIVE SUITE 250 TAMPA FL 33609

For Profit Atlanta



City: State:

Zip:


Enrollment: 14,590


CIO

1-813-490-8900 8995

[email protected] 5420 Bay Center Drive Suite 250 Tampa FL 33609 3/3/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Upen Patel



Legal Entity Name: HEALTHSPRING OF FLORIDA, INC.Organization Marketing Name: HealthSpring of Florida, Inc.

Parent Organization: HealthSpring, Inc.Local CCP Organization Type: Vice President of Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Wendy Wetzel 5/1/2005 Contract Effective Date: 1-832-553-3300 Phone: For Profit Tax Status: 3379Extension: Denver CMS Region Responsible: Fax:

Enrollment: 30,740 [email protected] Email: 2900 North Loop West Address:

11401 SW 40 Street, Suite 400 Legal Entity Address: Suite 1300 HoustonCity:

MIAMI City: TXState: FLState: 77092Zip: 33165 Zip: 2/10/2009Last Updated:





4630 Woodlands Corporate Blvd. Legal Entity Address: Hartford City:

Tampa City: CTState: FLState: 06156Zip: 33614 Zip: 8/24/2006Last Updated:

Contract Number: H5415 Legal Entity Name: HUMANA HEALTH INSURANCE COMPANY OF FL, INC.

Organization Marketing Name: Humana Health Insurance Company of FL, Inc. Parent Organization: Humana Inc.




Address: 101 East Main Street Legal Entity Address: 3501 SW 160th Avenue

City: Louisville City: Miramar State: KY



Organization Marketing Name: Spokane Community Care Parent Organization: Arcadian Management Services Inc.




Address: 825 Washington St. Suite 300 Legal Entity Address: 824 WASHINGTON STREET, SUITE 300

City: Oakland City: OAKLAND State: CA

State: WA Zip: 94607 Zip: 94607 Last Updated: 2/26/2008






4350 WEST CYPRESS STREET Legal Entity Address: CA124-0142 SUITE 1000 CyressCity: TAMPA City: CAState: FLState: 90630Zip: 33607 Zip: 4/14/2009Last Updated:

Contract Number: H5419 Legal Entity Name: BLUE CROSS OF CALIFORNIA








Contract Number: H5420 Legal Entity Name: MEDICA HEALTHCARE PLANS, INC.

Organization Marketing Name: Medica HealthCare Plans, Inc. Parent Organization: Medica HealthCare Plans, Inc.

Local CCP Organization Type: Contact Title: PSO (State License) Plan Type: Name: Jenny Curbelo 6/1/2005 Contract Effective Date: 1-800-407-9069 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-305-460-0616 Fax:

Enrollment: 15,850 [email protected] Email: 4000 Ponce De Leon Blvd.Address:

4000 Ponce de Leon Blvd. Legal Entity Address: Suite 650 Suite 650 Coral Gables City: CORAL GABLES City: FLState: FLState: 33146Zip: 33146 Zip: 8/18/2006Last Updated:



PFFS PFFS 8/1/2005


For Profit Dallas



City: State:

Zip:


Enrollment: 125,128



1-888-445-8699


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H5422 Legal Entity Name: BLUE CROSS BLUE SHIELD OF GEORGIA

Organization Marketing Name: Blue Cross Blue Shield Healthcare Plan of Georgia Parent Organization: Wellpoint, Inc.













Contract Number: H5425 Legal Entity Name: SCAN HEALTH PLAN

Organization Marketing Name: SCAN Health Plan Parent Organization: SCAN Health Plan, Inc.

Organization Type: Local CCP Contact Title: Vice President, Marketing Plan Type: HMO/HMOPOS Name: Hans Eckardt



Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Aiport Way Suite 100

Suite 100 City: Long Beach City: Long Beach State: CA


Contract Number: H5426 Legal Entity Name: HUMANA ADVANTAGECARE PLAN, INC.

Organization Marketing Name: Humana AdvantageCare Plan, Inc. Parent Organization: Humana Inc.




Address: 101 East Main Street Legal Entity Address: 3501 SW 160th Avenue

City: Louisville City: Miramar State: KY




Legal Entity Name: FREEDOM HEALTH PLAN, INC.Organization Marketing Name: Freedom Health, Inc.

Parent Organization: Freedom Health, Inc

Local CCP Organization Type: Sr. VP Operations Contact Title: HMO/HMOPOS Plan Type: Name: Chris O'Connor 9/1/2005 Contract Effective Date: 1-800-401-2740 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 32,475 [email protected] Email: 5403, Church Ave N, Address:

5403 N Church Avenue Legal Entity Address: TampaCity:


Contract Number: H5428 Legal Entity Name: SAN MATEO HEALTH COMMISSION

Organization Marketing Name: Health Plan of San Mateo Parent Organization: Health Plan of San Mateo

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: CareAdvntg UnitName: 9/1/2005 Contract Effective Date: 1-866-880-0606 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 7,422 [email protected] Email: 701 Gateway Blvd., Suite 400 Address:

701 GATEWAY BLVD., SUITE 400 Legal Entity Address: South San Francisco City:

SOUTH SAN FRANCISCO City: CAState: CAState: 94080Zip: 94080 Zip: 8/18/2006Last Updated:

Contract Number: H5429 Legal Entity Name: UNIVERSAL HEALTH CARE, INC.

Organization Marketing Name: Universal Health Care, Inc. Parent Organization: Universal Health Care Inc.

Local CCP Organization Type: COMPLIANCE OFFICER Contact Title: Local PPO Plan Type: Name: BRUCE R HOFFMAN 9/1/2005 Contract Effective Date: 1-866-690-4842 Phone: For Profit Tax Status: 6534Extension: Atlanta CMS Region Responsible: 1-727-823-3840 Fax:

Enrollment: 1,527 [email protected] Email: UNIVERSAL HEALTH CARE, INC. Address:

UNIVERSAL HEALTH CARE, INC. Legal Entity Address: 100 CENTRAL AVENUE , SUITE 200 100 CENTRAL AVENUE, SUITE 200 SAINT PETERSBURG City: SAINT PETERSBURG City: FLState: FLState: 33701Zip: 33701 Zip: 2/17/2009Last Updated:

Contract Number: H5430 Legal Entity Name: CARE1ST HEALTH PLAN OF ARIZONA

Organization Marketing Name: ONECare by Care1st Health Plan Arizona, Inc. Parent Organization: Care1st Health Plan

Organization Type: Local CCP Contact Title: Compliance Officer Plan Type: HMO/HMOPOS Name: Cheyenne Hollin



Address: 2355 E. Camelback Rd., Ste 300 Legal Entity Address: 2355 E. CAMELBACK ROAD, SUITE 300

City: Phoenix City: PHOENIX State: AZ



Contract Number: H5431 Legal Entity Name: HEALTHSUN HEALTH PLANS, INC.

Organization Marketing Name: HealthSun Health Plans, Inc. Parent Organization: HealthSun Health Plans, Inc

Local CCP Organization Type: Vice President Contact Title: HMO/HMOPOS Plan Type: Jonathan KleinName: 8/1/2005 Contract Effective Date: 1-305-234-9292 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-305-444-9148 Fax:

Enrollment: 2,994 [email protected] Email: 1205 SW 37th Avenue Address:

1205 SOUTHWEST 37TH AVENUE, 2ND FLOOR Legal Entity Address: MiamiCity:

MIAMI City: FLState: FLState: 33135Zip: 33135 Zip: 4/17/2007Last Updated:

Contract Number: H5433 Legal Entity Name: ORANGE COUNTY HEALTH AUTHORITY

Organization Marketing Name: OneCare Parent Organization: CalOptima

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: OneCare Customer Service 8/1/2005 Contract Effective Date: 1-877-412-2734 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 8,869 [email protected] Email: 1120 W. La Veta Avenue Address:

1120 WEST LA VETA AVENUE, 5TH FLOOR Legal Entity Address: OrangeCity:

ORANGE City: CAState: CAState: 92868Zip: 92868 Zip: 9/6/2006Last Updated:

Contract Number: H5434 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.

Organization Marketing Name: Blue Cross and Blue Shield of Florida, Inc. Parent Organization: Blue Cross and Blue Shield of Florida

Organization Type: Local CCP Contact Title: Manager B - Contact SFl Plan Type: Local PPO Name: Martha Garcia



Address: 8400 NW 33rd St Legal Entity Address: 4800 DEERWOOD CAMPUS PARKWAY Suite 100

City: Miami City: JACKSONVILLE State: FL



Organization Marketing Name: SecureHorizons MedicareDirect Parent Organization: UnitedHealth Group, Inc.

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Richard Irwin



Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA124-0142





Legal Entity Name: AVMED, INC.Organization Marketing Name: AvMed Medicare Preferred PPO

Parent Organization: AvMed, Inc.Organization Type: Local CCP Contact Title: Manager, Medicare Compliance

Plan Type: Local PPO Name: Jacqueline Crews Contract Effective Date: 7/1/2005 Phone: 1-352-372-8400

Tax Status: Not-for-Profit/Non-Profit Extension: 40832 CMS Region Responsible: Atlanta Fax: 1-352-337-8820

Enrollment: 169 Email: [email protected] Address: AvMed Health Plans

Legal Entity Address: 4300 N.W. 89th BLVD 4300 NW 89 Blvd. City: Gainesville

City: GAINESVILLE State: FL State: FL Zip: 32606





151 FARMINGTON AVENUE Legal Entity Address: Hartford City:


Contract Number: H5439 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY

Organization Marketing Name: Health Net Life Insurance Company Parent Organization: Health Net, Inc.

Organization Type: Local CCP Contact Title: Provider and Provider Directory Information Plan Type: Local PPO Name: Member Services


CMS Region Responsible: Seattle Fax: Enrollment: 697 Email: [email protected]

Address: P.O. Box 10198 Legal Entity Address: 21281 BURBANK BLVD.

Building B City: Van Nuys City: WOODLAND HILLS State: CA







Address: 5757 Plaza Dr Legal Entity Address: 4350 WEST CYPRESS STREET CA124-0142

SUITE 1000 City: Cyress City: TAMPA State: CA



Contract Number: H5449 Legal Entity Name: DAVITA VILLAGEHEALTH OF VIRGINIA, INC.

Organization Marketing Name: DaVita VillageHealth of Virginia, Inc. Parent Organization: Davita Inc







Enrollment: * [email protected]: 101 East Main Street Address:





Organization Type: PFFS Contact Title: Compliance Coordinator Plan Type: PFFS Name: Christine Cunningham



Address: 214 Dartmouth Avenue SW Legal Entity Address: 2600 Sixth Street SW

City: Canton City: Canton State: OH


Contract Number: H5501 Legal Entity Name: PEOPLES HEALTH, INC.

Organization Marketing Name: Peoples Health Parent Organization: Tenet Healthcare Corporation

Organization Type: Local CCP Contact Title: Plan Type: Local PPO Name: Member Services



Address: Three Lakeway Center Legal Entity Address: Three Lakeway Center 3838 N Causeway Blvd, Suite 2200

3838 N Causeway Blvd., Suite 2200 City: Metairie City: Metairie State: LA







9900 bren Road East Legal Entity Address: CA124-0142 CyressCity:


Contract Number: H5508 Legal Entity Name: ADVANTAGE HEALTH SOLUTIONS, INC.

Organization Marketing Name: Advantage Health Solutions, Inc. Parent Organization: Advantage Health Solutions

Local CCP Organization Type: Manager of Marketing and Enrollment Strategies Contact Title: Local PPO Plan Type: Name: Cynthia Stepp 1/1/2006 Contract Effective Date: 1-317-573-7954 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 2,499 [email protected] Email: 9045 River Road, Suite 200 Address:

9045 River Road, Suite 200 Legal Entity Address: Indianapolis City:

Indianapolis City: INState: INState: 46240Zip: 46240 Zip: 10/23/2008Last Updated:

Contract Number: H5509 Legal Entity Name: COVENTRY HEALTH AND LIFE INS. COMPANY

Organization Marketing Name: Coventry Health And Life Ins. Company Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Manager, Medicare Compliance Plan Type: Local PPO Name: Gail D Howard-King



Address: 8320 Ward Parkway Legal Entity Address: 500 Virginia Street, Suite 400

City: Kansas City City: Charleston State: MO

State: WV Zip: 64114 Zip: 25326 Last Updated: 12/3/2007
























Contract Number: H5517 Legal Entity Name: COVENTRY HEALTH AND LIFE INS. COMPANY

Organization Marketing Name: Advantra PPO Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: VP Medicare Compliance Officer Plan Type: Local PPO Name: Mary Ninos



Address: 6710 Rockledge Dr Legal Entity Address: 6705 Rockledge Drive Bldg B, 5th Fl

Suite 900 City: Bethesda City: Bethesda State: MD


Contract Number: H5520 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY

Organization Marketing Name: Health Net Medicare Advantage Parent Organization: Health Net, Inc.

Organization Type: Local CCP Contact Title: Provider and Provider Directory Information Plan Type: Local PPO Name: Member Services



Address: 13221 SW 68th Parkway Legal Entity Address: 13221 SW 68th Parkway, Ste. 200

City: Tigard City: Tigard State: OR

State: OR Zip: 97223-8328 Zip: 97223 Last Updated: 8/21/2006










Contract Number: H5522 Legal Entity Name: HEALTHASSURANCE PENNSYLVANIA, INC.


Organization Type: Local CCP Contact Title: Director, Regulatory Compliance Plan Type: Local PPO Name: Barbara Sellman



Address: 11 Stanwix Street Legal Entity Address: 11 Stanwix Street Suite 2300



Contract Number: H5523 Legal Entity Name: CARITEN INSURANCE COMPANY





Address: 101 East Main Street Legal Entity Address: 500 West Main St



Contract Number: H5525 Legal Entity Name: OSF HEALTHPLANS, INC.

Organization Marketing Name: Humana Benefit Plan of Illinois, Inc. Parent Organization: Humana Inc.









Legal Entity Name: HEALTHNOW NEW YORK INC.Organization Marketing Name: Forever Blue Medicare PPO

Parent Organization: HealthNow New York Inc.Organization Type: Local CCP Contact Title: Division Mgr, Commercial Gov't Programs

Plan Type: Local PPO Name: Linda Warren Contract Effective Date: 1/1/2006 Phone: 1-518-220-4699

Tax Status: Not-for-Profit/Non-Profit Extension: CMS Region Responsible: New York Fax:

Enrollment: 18,814 Email: [email protected] Address: 30 Century Hill Drive

Legal Entity Address: 257 West Genesee Street City: Latham

City: Buffalo State: NY State: NY Zip: 12110

Zip: 14202 Last Updated: 9/3/2008 Contract Number: H5528 Legal Entity Name: GROUP HEALTH INCORPORATED

Organization Marketing Name: GHI Medicare PPO Parent Organization: EmblemHealth Inc.

Local CCP Organization Type: Manager Medicare Programs Contact Title: Local PPO Plan Type: Name: Peggy Fry 1/1/2006 Contract Effective Date: 1-866-557-7300 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 20,232 [email protected] Email: 80 Wolf RoadAddress:

80 Wolf Road Legal Entity Address: 6th Floor 6th Floor AlbanyCity: Albany City: NYState: NYState: 12205Zip: 12206 Zip: 2/18/2009Last Updated:

Contract Number: H5529 Legal Entity Name: COMMUNITY INSURANCE COMPANY








Contract Number: H5530 Legal Entity Name: ANTHEM HEALTH PLANS OF KENTUCKY, INC.























Contract Number: H5533 Legal Entity Name: UPMC HEALTH NETWORK


Local CCP Organization Type: Medicare Hotline Contact Title: Local PPO Plan Type: UPMC Health PlanName: 1/1/2006 Contract Effective Date: 1-877-381-3765 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 1,723 [email protected] Email: 112 Washington PlaceAddress:

112 Washington Place Legal Entity Address: PittsburghCity:

Pittsburgh City: PAState: PAState: 15219Zip: 15219 Zip: 9/1/2006Last Updated:

Contract Number: H5549 Legal Entity Name: VNS CHOICE

Organization Marketing Name: VNS CHOICE Medicare Parent Organization: Visiting Nurse Service of New York


107 E 70th Street

New York NY 10021




City: State:

Zip:


Enrollment: 2,452


Director, Compliance and Regulatory Affairs

1-866-783-1444

[email protected] 1250 Broadway 11th Floor New York NY 10001 6/2/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Karl Dehm


Contract Number: H5554 Legal Entity Name: SANTA CLARA COUNTY HEALTH AUTHORITY

Organization Marketing Name: Santa Clara Family Health Plan Parent Organization: SANTA CLARA COUNTY HEALTH AUTHORITY

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Pat McClelland Name: 1/1/2007 Contract Effective Date: 1-866-472-3691 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 4,054 [email protected] Email: 210 E. Hacienda Avenue Address:

210 E. Hacienda Avenue Legal Entity Address: Campbell City:

CampbellCity: CAState: CAState: 95008Zip: 95008 Zip: 9/11/2008Last Updated:

Contract Number: H5575 Legal Entity Name: FIDELIS SECURECARE OF NORTH CAROLINA

Organization Marketing Name: Fidelis SecureCare of North Carolina Parent Organization: Fidelis SecureCare

Organization Type: Local CCP Contact Title: Manager - Customer Services-Production Plan Type: HMO/HMOPOS Name: Ron Rome



Address: 201 Lackawanna Avenue Legal Entity Address: 9300 Harris Corners Parkway

Suite 100 City: Scranton City: Charlotte State: PA


Contract Number: H5576 Legal Entity Name: VANTAGE HEALTH PLAN, INC.

Organization Marketing Name: Vantage Health Plan, Inc. Parent Organization: Vantage Health Plan, Inc.

Organization Type: Local CCP Contact Title: Director of Compliance Plan Type: HMO/HMOPOS Name: Keith McRee


CMS Region Responsible: Dallas Fax: 1-318-361-2159 Enrollment: 3,628 Email: [email protected]

Address: 130 DeSiard St Legal Entity Address: 130 DeSiard St Suite 300

Suite 300 City: Monroe City: Monroe State: LA


Contract Number: H5577 Legal Entity Name: MCS ADVANTAGE INC.



MCS Plaza, Suite 201 255 Ponce De Leon Ave. San Juan PR 00917

For Profit New York



City: State:

Zip:


Enrollment: 39,466


VP A- Medicare Compliance

1-787-758-2500 4547 1-787-620-6906 [email protected] MCS Plaza 255 Ponce de Leon Avenue, Second Floor San Juan PR 00918 3/6/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Carlos J Fournier


Contract Number: H5578 Legal Entity Name: ARCADIAN HEALTH PLAN OF GEORGIA, INC.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/2007 Contract Effective Date: 1-800-573-8597 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:


825 WASHINGTON STREET, SUITE 300 Legal Entity Address: OaklandCity:


Contract Number: H5580 Legal Entity Name: SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION

Organization Marketing Name: Mercy Care Advantage Parent Organization: Southwest Catholic Health Network

Organization Type: Local CCP Contact Title: Director, Customer and Enrollment Services Plan Type: HMO/HMOPOS Name: Cathy Waldbillig



Address: 4350 E. Cotton Center Boulevard Legal Entity Address: 4350 E. Cotton Center Boulevard Bldg D

Bldg D City: Phoenix City: Phoenix State: AZ


Contract Number: H5587 Legal Entity Name: HEALTH CHOICE ARIZONA, INC.

Organization Marketing Name: Health Choice Generations Parent Organization: IASIS Healthcare

Local CCP Organization Type: Plan Directory Contact for Public Website Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2006 Contract Effective Date: 1-800-656-8991 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-480-784-2933 Fax:

Enrollment: 3,484 [email protected] Email: 410 N 44th Street, Suite 510 Address:

410 N 44th Street Legal Entity Address: Suite 510 PhoenixCity: Phoenix City: AZState: AZState: 85008Zip: 85008 Zip: 4/23/2009Last Updated:

Contract Number: H5588 Legal Entity Name: MOLINA HEALTHCARE OF NEVADA, INC.

Organization Marketing Name: Molina Healthcare of Nevada Parent Organization: Molina Healthcare, Inc.,

Organization Type: Local CCP Contact Title: Vice President Plan Type: HMO/HMOPOS Name: Richard G Slaughter



Address: 200 Oceangate Legal Entity Address: 7050 S. Union Park Center, Suite 200 Ste. 100

City: Long Beach City: Midvale State: CA

State: UT Zip: 90802 Zip: 84047 Last Updated: 2/19/2008


Contract Number: H5590 Legal Entity Name: BRIDGEWAY HEALTH SOLUTIONS

Organization Marketing Name: Advantage by Bridgeway Health Solutions Parent Organization: Centene Corporation

Local CCP Organization Type: DirectorContact Title: HMO/HMOPOS Plan Type: Name: Elaine Teune 1/1/2008 Contract Effective Date: 1-866-475-3129 Phone: For Profit Tax Status: 26812Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 372 [email protected] Email: 1501 W Fountainhead Parkway Address:

15101 West Fountainhead ParkwayLegal Entity Address: suite #201 TempeCity:

Tempe City: AZState: AZState: 85282Zip: 85282 Zip: 5/31/2007Last Updated:

Contract Number: H5591 Legal Entity Name: MARTIN'S POINT GENERATIONS, LLC

Organization Marketing Name: Martin's Point Generations Advantage Parent Organization: Martin's Point Health Care, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Marketing Representative 1/1/2007 Contract Effective Date: 1-888-640-4423 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 2,331 [email protected] Email: P. O. Box 9746 Address:

P.O. Box 9746 Legal Entity Address: 891 Washington Avenue 331 Veranda Street PortlandCity: Portland City: MEState: MEState: 04104Zip: 04104 Zip: 8/23/2006Last Updated:

Contract Number: H5594 Legal Entity Name: OPTIMUM HEALTHCARE, INC.

Organization Marketing Name: Optimum HealthCare, Inc. Parent Organization: Optimum HealthCare, Inc.

Local CCP Organization Type: Director, Sales Operations Contact Title: HMO/HMOPOS Plan Type: Robin Florez Name: 1/1/2007 Contract Effective Date: 1-813-506-6111 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 4,533 [email protected] Email: 5403, Church Ave N, Address:

5403 N. Church Ave Legal Entity Address: TampaCity:


Contract Number: H5606 Legal Entity Name: STERLING LIFE INSURANCE COMPANY

Organization Marketing Name: Fresenius Medical Health Plan, Inc. - Pennsylvania Parent Organization: Munich American Holding Corporation

Demo ESRD I - PFFS 1/1/2006

2219 Rimland Drive PO Box 5348 Bellingham WA 982275348

For Profit Seattle



City: State:

Zip:


Enrollment: 129



1-360-647-9080 29073


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendi Western


Contract Number: H5608 Legal Entity Name: DENVER HEALTH MEDICAL PLAN, INC.

Organization Marketing Name: Denver Health Medical Plan Parent Organization: Denver Healthcare Hospital Authority

Local CCP Organization Type: Medicare ProgramManager Contact Title: HMO/HMOPOS Plan Type: Beth HenchelName: 1/1/2006 Contract Effective Date: 1-720-956-2334 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: 1-720-956-2368 Fax:

Enrollment: 2,608 [email protected] Email: 777 Bannock Street Address:

777 Bannock Street Legal Entity Address: Mail Code 6000 mail code 6000 DenverCity: Denver City: COState: COState: 80204Zip: 80204 Zip: 3/24/2009Last Updated:

Contract Number: H5609 Legal Entity Name: GEMCARE HEALTH PLAN INC.

Organization Marketing Name: GEMCARE Health Plan Parent Organization: Golden Empire Managed Care

Local CCP Organization Type: Marketing Manager Contact Title: HMO/HMOPOS Plan Type: Name: Ana Igoa 1/1/2007 Contract Effective Date: 1-877-697-2464 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 6,376 [email protected] Email: 4550 California Avenue Address:

4550 California Avenue Legal Entity Address: Suite 100 Suite 100 BakersfieldCity: BakersfieldCity: CAState: CAState: 93309Zip: 933091669 Zip: 10/10/2008Last Updated:

Contract Number: H5610 Legal Entity Name: CARE RESOURCES, INC.

Organization Marketing Name: Care Resources Parent Organization: CARE RESOURCES, INC.

Organization Type: National PACE Contact Title: Claims ManagerPlan Type: National PACE Name: Becky Haggerty

Contract Effective Date: 9/1/2006 Phone: 1-616-956-9440

Tax Status: Not-for-Profit/Non-Profit Extension: 2178 CMS Region Responsible: Chicago Fax: 1-616-285-2588

Enrollment: 141 Email: [email protected] Address: 2100 Raybrook Ave SE

Legal Entity Address: 1471 Grace Street SE Suite 203 City: Grand Rapids

City: Grand Rapids State: MI State: MI Zip: 49546

Zip: 49506 Last Updated: 4/3/2009 Contract Number: H5619 Legal Entity Name: ARCADIAN HEALTH PLAN, INC.

Organization Marketing Name: Northeast Community Care Parent Organization: Arcadian Management Services Inc.




Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street, Suite 300




Contract Number: H5628 Legal Entity Name: MOLINA HEALTHCARE OF UTAH, INC.

Organization Marketing Name: Molina Healthcare of Utah Parent Organization: Molina Healthcare, Inc.,

Organization Type: Local CCP Contact Title: Vice President Plan Type: HMO/HMOPOS Name: Richard G Slaughter



Address: 200 Oceangate Legal Entity Address: 7050 Union Park Center Ste. 100

Suite 200 City: Long Beach City: Midvale State: CA

State: UT Zip: 90802 Zip: 84047 Last Updated: 2/19/2008

Contract Number: H5629 Legal Entity Name: COMMUNITY ELDERCARE OF SAN DIEGO

Organization Marketing Name: St. Paul's PACE Parent Organization: Community Eldercare of San Diego

National PACE Organization Type: Executive Director Contact Title: National PACE Plan Type: Name: John A Allgood 2/1/2008 Contract Effective Date: 1-619-239-6900 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-619-239-1256 Fax:

Enrollment: 57 [email protected] Email: 328 Maple StreetAddress:

328 Maple Street Legal Entity Address: San Diego City:

San DiegoCity: CAState: CAState: 92103Zip: 92103 Zip: 1/23/2008Last Updated:

Contract Number: H5640 Legal Entity Name: IEHP HEALTH ACCESS

Organization Marketing Name: IEHP Medicare DualChoice Parent Organization: INLAND EMPIRE HEALTH PLAN

Organization Type: Local CCP Contact Title: Member Services Plan Type: HMO/HMOPOS Name: Member Services



Address: 303 E. Vanderbilt Way, Suite 100 Legal Entity Address: 303 E. Vanderbilt Way

Suite 100 City: San Bernardino City: San Bernardino State: CA


Contract Number: H5649 Legal Entity Name: CENTRAL HEALTH PLAN OF CALIFORNIA, INC.

Organization Marketing Name: Central Health Medicare Plan Parent Organization: Central Health Plan of California


1540 Bridgegate Drive

Diamond Bar CA 91765




City: State:

Zip:


Enrollment: 4,500


Member Services

1-866-314-2427

1-626-388-2361 [email protected] 1540 Bridgegate Drive

Diamond Bar CA 91765 1/7/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:









Contract Number: H5656 Legal Entity Name: SELECTCARE HEALTH PLANS, INC.






Suite 800 City: Houston City: Houston State: TX


Contract Number: H5657 Legal Entity Name: HUMANA INSURANCE COMPANY OF NEW YORK

Organization Marketing Name: Humana Insurance Company of New York Parent Organization: Humana Inc.





Contract Number: H5665 Legal Entity Name: CARE IMPROVEMENT PLUS OF MARYLAND, INC.

Organization Marketing Name: Care Improvement Plus Parent Organization: XLHealth Corporation


351 West Camden Street. Suite 100 Baltimore MD 21201




City: State:

Zip:


Enrollment: 1,173


Marketing Manager

1-410-625-2200

[email protected] 351 West Camden Street Suite 100 Baltimore MD 21201 4/16/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Misty Smith






9900 Bren Road East Legal Entity Address: CA124-0142 MN008-W130 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H5679 Legal Entity Name: HMO COLORADO, INC.








Contract Number: H5685 Legal Entity Name: MIDWEST HEALTH PLAN, INC.

Organization Marketing Name: Midwest Advantage Parent Organization: Midwest Health Plan, Inc.

Organization Type: Local CCP Contact Title: DIRECTOR OF CUSTOMER SERVICES Plan Type: HMO/HMOPOS Name: Pat Vier



Address: 5050 SCHAEFER ROAD Legal Entity Address: 5050 Schaefer Road

City: DEARBORN City: Dearborn State: MI

State: MI Zip: 48126 Zip: 48126 Last Updated: 3/26/2009

Contract Number: H5696 Legal Entity Name: PHYSICIANS UNITED PLAN, INC.

Organization Marketing Name: PUP Parent Organization: Physician's United Plan, Inc.




Address: 6220 S. Orange Blossom Trail Legal Entity Address: 483 North Semoran Boulevard

City: Orlando City: Winter Park State: FL








Contract Number: H5698 Legal Entity Name: WINDSOR HEALTH PLANS, INC.

Organization Marketing Name: Windsor Medicare Extra Parent Organization: Windsor Health Group

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/2006 Contract Effective Date: 1-800-811-8482 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 28,221 [email protected] Email: 7100 Commerce Way, Ste 285 Address:

7100 Commerce Way, Ste 285 Legal Entity Address: BrentwoodCity:

Brentwood City: TNState: TNState: 37027Zip: 37027 Zip: 11/1/2007Last Updated:

Contract Number: H5700 Legal Entity Name: ARKANSAS COMMUNITY CARE, INC.

Organization Marketing Name: Arkansas Community Care, Inc. Parent Organization: Arcadian Management Services Inc.




Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington St. Suite 300



Contract Number: H5703 Legal Entity Name: SOUTH COUNTRY HEALTH ALLIANCE

Organization Marketing Name: South Country Health Alliance Parent Organization: South Country Health Alliance


110 West Fremont Street

Owatonna MN 55060




City: State:

Zip:


Enrollment: 708


Marketing and Communications Manager

1-507-431-6074

1-507-444-7774 [email protected] 110 West Fremont Street

Owatonna MN 55060 3/30/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Ellen Lewis


Contract Number: H5721 Legal Entity Name: HEALTH NET INSURANCE OF NEW YORK, INC.

Organization Marketing Name: Health Net Pearl Parent Organization: Health Net, Inc.

Organization Type: PFFS Contact Title: Provider and Provider Directory Information Plan Type: PFFS Name: Member Services



Address: 2019 Aerojet Rd., Mail Stop: CA-167-01-26 Legal Entity Address: 399 Knollwood Road, Suite 113

City: Rancho Cordova City: White Plains State: CA

State: NY Zip: 95742-6418 Zip: 10603 Last Updated: 3/14/2007


Organization Marketing Name: Triple-S Salud, INC. Parent Organization: Triple-S Management Corporation

Organization Type: Local CCP Contact Title: Customer Service Manager Plan Type: HMO/HMOPOS Name: Armando Gonzalez



Address: 1441 Franklin D. Roosevelt Ave. Legal Entity Address: P. O. Box 363628





Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Aetna Customer Service






Contract Number: H5746 Legal Entity Name: AMERIGROUP NEW MEXICO, INC.

Organization Marketing Name: AMERIGROUP Community Care of New Mexico Parent Organization: AMERIGROUP Corporation




Address: AMERIGROUP Corporation Legal Entity Address: 2132-A #150 Central Avenue, SE 4425 Corporation Lane

City: Virginia Beach City: Alburquerque State: VA







9900 Bren Road East Legal Entity Address: CA124-0142 Mail Route MN-008-W140 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H5750 Legal Entity Name: METROPOLITAN HEALTH PLAN

Organization Marketing Name: North Star Advantage / North Star Advantage Plus Parent Organization: Metropolitan Health Plan

Organization Type: Local CCP Contact Title: Government Programs Manager Plan Type: HMO/HMOPOS Name: Susan Sommers



Address: 400 South 4th Street Legal Entity Address: 400 South Fourth Street Suite 201

Suite 201 City: Minneapolis City: Minneapolis State: MN







Contract Number: H5760 Legal Entity Name: MCS ADVANTAGE, INC.

Organization Marketing Name: CosviMed Care Parent Organization: Cooperativa de Seguros de Vida de Puerto Rico


PO BOX 363428

SAN JUAN PR 00936




City: State:

Zip:


Enrollment: 6,735


VP A- Medicare Compliance

1-787-758-2500 4547 1-787-620-6906 [email protected] MCS Plaza 255 Ponce de Leon Avenue, Second Floor San Juan PR 00918 5/14/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Carlos J Fournier


Contract Number: H5774 Legal Entity Name: AMERICAN HEALTH, INC.

Organization Marketing Name: American Health Medicare Parent Organization: American Health Plan

Local CCP Organization Type: Chief Sales and Marketing Officer Contact Title: HMO/HMOPOS Plan Type: Name: Kevin Grace 1/1/2006 Contract Effective Date: 1-787-620-1919 Phone: For Profit Tax Status: 4040Extension: New York CMS Region Responsible: 1-787-620-0929 Fax:

Enrollment: 24,252 [email protected] Email: American Health Medicare Address:

Microsoft Building Metro Office Park Suite 300 Lot 18 Legal Entity Address: P.O. Box 11320 San JuanCity:

Guaynabo City: PRState: PRState: 00922Zip: 00922 Zip: 11/11/2008Last Updated:

Contract Number: H5782 Legal Entity Name: PARTNERSHIP HEALTHPLAN OF CALIFORNIA

Organization Marketing Name: Partnership HealthPlan of California Parent Organization: PARTNERSHIP HEALTHPLAN OF CALIFORNIA

Local CCP Organization Type: Data Entry and Enrollment Unit Coordinator Contact Title: HMO/HMOPOS Plan Type: Name: Lisa Harrison 1/1/2007 Contract Effective Date: 1-800-863-4155 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-707-863-4415 Fax:

Enrollment: 3,480 [email protected] Email: 360 Campus Lane, Suite 100 Address:

360 Campus Lane Legal Entity Address: Suite 100 FairfieldCity: FairfieldCity: CAState: CAState: 94534Zip: 94534 Zip: 8/4/2008Last Updated:






Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street, Suite 300

City: Oakland City: OAkland State: CA











MOLINA HEALTHCARE OF CALIFORNIA H5810


Molina Healthcare of CaliforniaOrganization Marketing Name: Molina Healthcare, Inc., Parent Organization: Local CCP HMO/HMOPOS 1/1/2006

200 Oceangate Suite 100

Long Beach CA 90802

For Profit Denver



City: State:

Zip:


Enrollment: 1,612


Vice President

1-562-901-1080

1-562-628-2382 [email protected] 200 Oceangate Ste. 100 Long Beach CA 90802 2/19/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Richard G Slaughter

MEDCORE HP H5811


Organization Marketing Name: Medcore HP Medcore HPParent Organization: Local CCP HMO/HMOPOS 1/1/2006

2609 E. Hammer Lane

Stockton CA 95210




City: State:

Zip:


Enrollment: 2,060


Customer Services Supervisor

1-800-320-5688

1-209-320-2644 [email protected] 2609 E. Hammer Lane

Stockton CA 95210 12/22/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Darlene Torres

GEISINGER INDEMNITY INSURANCE COMPANY H5812


Organization Marketing Name: Geisinger Gold Geisinger Health System Parent Organization: PFFS PFFS 1/1/2006

100 North Academy Avenue

Danville PA 178223220




City: State:

Zip:


Enrollment: 1,615


Director of Customer Service

1-800-498-9731 16159 1-570-271-5970 [email protected] 100 North Academy Avenue

Danville PA 17822-3229 11/11/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Renee BlasiName:

AETNA HEALTH, INC H5813


Organization Marketing Name: Aetna Medicare Aetna Inc.Parent Organization: Local CCP HMO/HMOPOS 1/1/2007

151 Farmington Avenue

Hartford CT 06156

For Profit Boston



City: State:

Zip:


Enrollment: 940


1-800-445-1796

[email protected] 151 Farmington Avenue

Hartford CT 06156 8/25/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Aetna Customer Service


Contract Number: H5817 Legal Entity Name: AMERIGROUP TEXAS, INC.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Dedicated Services UnitName: 1/1/2006 Contract Effective Date: 1-866-805-4589 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 5,546 [email protected] Email: AMERIGROUP Corporation Address:

1200 EAST COPELAND ROAD, SUITE 200, Legal Entity Address: 4425 Corporation Lane Virginia Beach City:

ARLINGTON City: VAState: TXState: 23462Zip: 76011 Zip: 2/3/2009Last Updated:

Contract Number: H5820 Legal Entity Name: UNIVERSAL HEALTH CARE INSURANCE COMPANY

Organization Marketing Name: UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC. Parent Organization: Universal Health Care Inc.

Organization Type: PFFS Contact Title: COMPLIANCE OFFICER Plan Type: PFFS Name: BRUCE R HOFFMAN



Address: UNIVERSAL HEALTH CARE, INC. Legal Entity Address: 100 CENTRAL AVENUE 100 CENTRAL AVENUE , SUITE 200

SUITE 200 City: SAINT PETERSBURG City: SAINT PETERSBURG State: FL


Contract Number: H5821 Legal Entity Name: MAPFRE LIFE INSURANCE COMPANY

Organization Marketing Name: MAPFRE LIFE INSURANCE COMPANY Parent Organization: MAPFRE PRAICO CORPORATION

Local CCP Organization Type: Medicare Coordinator Contact Title: HMO/HMOPOS Plan Type: Marlene Pierce Name: 1/1/2006 Contract Effective Date: 1-787-250-6500 Phone: For Profit Tax Status: 7080Extension: New York CMS Region Responsible: 1-787-772-8886 Fax:


Urb. Tres Monjitas Industrial Legal Entity Address: 297 Carlos Chard≤n Ave. San JuanCity: San Juan City: PRState: PRState: 00936-8297 Zip: 009181410 Zip: 12/4/2007Last Updated:

Contract Number: H5822 Legal Entity Name: MIDLAND CARE CONNECTION

Organization Marketing Name: Midland PACE Parent Organization: MIDLAND HOSPICE, INC.


200 SW Frazier Circle

Topeka KS 66606

Not-for-Profit/Non-Profit Kansas City



City: State:

Zip:


Enrollment: 51


IT Coordinator

1-785-232-2044

[email protected] 200 SW Frazier Circle

Topeka KS 66606 10/25/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Dreux Doty


Contract Number: H5823 Legal Entity Name: MOLINA HEALTHCARE OF WASHINGTON, INC.

Organization Marketing Name: Molina Healthcare of Washington, Inc. Parent Organization: Molina Healthcare, Inc.,

Local CCP Organization Type: Vice President Contact Title: HMO/HMOPOS Plan Type: Name: Richard G Slaughter 1/1/2006 Contract Effective Date: 1-562-901-1080 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: 1-562-628-2382 Fax:

Enrollment: 963 [email protected] Email: 200 Oceangate Address:

21540 30th Dr. SE Legal Entity Address: Ste. 100 Suite 400 Long Beach City: BothellCity: CAState: WAState: 90802Zip: 98021 Zip: 2/19/2008Last Updated:

Contract Number: H5826 Legal Entity Name: COMMUNITY HEALTH PLAN OF WASHINGTON

Organization Marketing Name: Community HealthFirst Medicare Advantage Plan Parent Organization: Community Health Plan of Washington

Local CCP Organization Type: Director of Medicare Sales Contact Title: HMO/HMOPOS Plan Type: Kris PringleName: 1/1/2007 Contract Effective Date: 1-206-613-8972 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-206-521-8834 Fax:

Enrollment: 3,804 [email protected] Email: 720 Olive WayAddress:

720 Olive Way Legal Entity Address: Suite 300 Suite 300 SeattleCity: Seattle City: WAState: WAState: 98101-1830 Zip: 981011830 Zip: 5/6/2008Last Updated:







Contract Number: H5839 Legal Entity Name: STERLING LIFE INSURANCE COMPANY (MT)

Organization Marketing Name: Sterling Life Insurance Company Parent Organization: Munich American Holding Corporation

PFFS PFFS 1/1/2006

2219 Rimland Dr

Bellingham WA 98227

For Profit Seattle



City: State:

Zip:


Enrollment: 329



1-360-647-9080 29073


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendi Western


Contract Number: H5849 Legal Entity Name: ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS.

Organization Marketing Name: Arkansas Blue Cross - Medi-Pak Advantage Parent Organization: Arkansas Blue Cross Blue Shield

Organization Type: PFFS Contact Title: Manager Medicare Operations Plan Type: PFFS Name: Delena C Hicks



Address: 320 W. Capitol, Suite 400 Legal Entity Address: 601 Gaines Street

City: Little Rock City: Little Rock State: AR

State: AR Zip: 72203 Zip: 72201 Last Updated: 2/3/2009

Contract Number: H5850 Legal Entity Name: SUMMIT HEALTH PLAN, INC.

Organization Marketing Name: Summit Health Plan, Inc. Parent Organization: Coventry Health Care Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Summit Customer Service






Contract Number: H5852 Legal Entity Name: AIDS HEALTHCARE FOUNDATION

Organization Marketing Name: POSITIVE HEALTHCARE PARTNERS Parent Organization: AIDS Healthcare Foundation

Organization Type: Local CCP Contact Title: Health Plan Adminstrator Plan Type: HMO/HMOPOS Name: Michael O'Malley



Address: 1001 N. Martel Ave. Legal Entity Address: 6255 WEST SUNSET BLVD 21ST FLOOR

City: LOS ANGELES City: LOS ANGELES State: CA


Contract Number: H5854 Legal Entity Name: ANTHEM HEALTH PLANS, INC





Address: P.O. Box 1407 Legal Entity Address: 1 WellPoint Way Church Street Station

CAT201-C004 City: New York City: Thousand Oaks State: NY



Contract Number: H5859 Legal Entity Name: HEALTH PLAN OF CAREOREGON, INC.

Organization Marketing Name: CareOregon Advantage Parent Organization: CareOregon, Inc.

Local CCP Organization Type: Member Services Supervisor Contact Title: HMO/HMOPOS Plan Type: Name: David Lima 1/1/2006 Contract Effective Date: 1-800-224-4840 Phone: For Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-503-416-3720 Fax:

Enrollment: 5,363 [email protected] Email: CareOregon Advantage Address:

315 SW Fifth Ave. Suite 900 Legal Entity Address: 315 SW Fifth Avenue, Suite 900 PortlandCity:

Portland City: ORState: ORState: 97204Zip: 97204 Zip: 5/1/2007Last Updated:

Contract Number: H5862 Legal Entity Name: BLUE CROSS OF IDAHO HEALTH SERVICES, INC.


PFFS Organization Type: Customer Service Manager, Medicare Advantage Plans Contact Title: PFFS Plan Type: Name: Sheri Core 1/1/2007 Contract Effective Date: 1-208-395-8205 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-208-387-6811 Fax:

Enrollment: 1,286 [email protected] Email: 3000 E. Pine Ave. Address:

3000 E. Pine Avenue Legal Entity Address: Meridian City:

Meridian City: IDState: IDState: 83642Zip: 83642 Zip: 8/27/2007Last Updated:







Contract Number: H5883 Legal Entity Name: BLUE CARE NETWORK OF MICHIGAN

Organization Marketing Name: Blue Care Network Parent Organization: Blue Cross Blue Shield of Michigan


20500 Civic Center Drive

Southfield MI 48076




City: State:

Zip:


Enrollment: 30,048


Manager, Provider Affairs

1-800-344-8525

[email protected] 20500 Civic Center Dr.

Southfield MI 48076 4/21/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Ashley Mabbitt Name:


Contract Number: H5884 Legal Entity Name: BLUECROSS BLUESHIELD OF TENNESSEE


PFFS Organization Type: Supervisor Medicare Advantage Operations Contact Title: PFFS Plan Type: Name: Carol Troxell 1/1/2006 Contract Effective Date: 1-800-841-7434 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:




Contract Number: H5887 Legal Entity Name: FIRST MEDICAL HEALTH PLAN, INC.

Organization Marketing Name: First Medical Health Plan, Inc. Parent Organization: First Medical Health Plan

Organization Type: Local CCP Contact Title: Compliance Officer Plan Type: HMO/HMOPOS Name: Alejandra Echevarria



Address: P.O. Box 195200 Legal Entity Address: P.O. Box 191580



Contract Number: H5895 Legal Entity Name: CONTRA COSTA CO MED SVCS DBA CONTRA COSTA HEALTH

Organization Marketing Name: Contra Costa Health Plan Parent Organization: Contra Costa Health Services

Organization Type: Local CCP Contact Title: Director of Marketing and Member Services Plan Type: HMO/HMOPOS Name: Teresa O'Riva

Contract Effective Date: 1/1/2007 Phone: 1-925-957-7221 Tax Status: Not Applicable Extension:


Address: 595 Center Ave. Ste. 100 Legal Entity Address: 595 Center Ave. Ste. 100

City: Martinez City: Martinez State: CA


Contract Number: H5896 Legal Entity Name: AMERIGROUP MARYLAND, INC.





Address: AMERIGROUP Corporation Legal Entity Address: 7550 Teague Road, Suite 500 4425 Corporation Lane

City: Virginia Beach City: Hanover State: VA



Contract Number: H5908 Legal Entity Name: BANNER MEDISUN, INC.

Organization Marketing Name: MediSun CareOptions Parent Organization: Banner Health

PFFS Organization Type: Contact Title: PFFS Plan Type: Name: Member Services 1/1/2006 Contract Effective Date: 1-800-446-8331 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-623-974-7439 Fax:

Enrollment: 72 [email protected] Email: P.O. Box 1489 Address:

P.O. Box 1489 Legal Entity Address: 13632 N. 99th Ave. Suite B 13632 N. 99th Ave, Suite B Sun CityCity: Sun City City: AZState: AZState: 85372Zip: 85372 Zip: 9/15/2008Last Updated:

Contract Number: H5909 Legal Entity Name: AMERICAN PROGRESSIVE LIFE AND HEALTH OF NEW YORK


Demo Organization Type: Member Service Representative Contact Title: ESRD I - PFFS Plan Type: Name: Member Services 1/1/2006 Contract Effective Date: 1-866-230-2513 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 90 [email protected] Email: 4888 Loop Central Drive Address:

c/o HHS Texas Management Legal Entity Address: Suite 900 4888 Loop Central Drive, Suite 800 HoustonCity: Houston City: TXState: TXState: 77081Zip: 77081 Zip: 12/9/2008Last Updated:






Contract Number: H5926 Legal Entity Name: MOLINA HEALTHCARE OF MICHIGAN

Organization Marketing Name: Molina Healthcare of Michigan Parent Organization: Molina Healthcare, Inc.,


100 W. Big Beaver Suite 600 Troy MI 48084

For Profit Denver



City: State:

Zip:


Enrollment: 2,036


Vice President

1-562-901-1080


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H5928 Legal Entity Name: CARE1ST HEALTH PLAN

Organization Marketing Name: Care1st Medicare Advantage Plan Parent Organization: Care1st Health Plan

Local CCP Organization Type: Pharmacy Director Contact Title: HMO/HMOPOS Plan Type: Michael Lasconia Name: 1/1/2007 Contract Effective Date: 1-323-889-6638 Phone: For Profit Tax Status: 6532Extension: San Francisco CMS Region Responsible: 1-323-889-6254 Fax:

Enrollment: 11,616 [email protected] Email: 601 Potrero Grande Drive Address:

601 Potrero Grande Legal Entity Address: Monterey ParkCity:

Monterey Park City: CAState: CAState: 91755Zip: 917557407 Zip: 7/2/2007Last Updated:

Contract Number: H5932 Legal Entity Name: GATEWAY HEALTH PLAN, INC.

Organization Marketing Name: Gateway Health Plan Medicare Assured Parent Organization: Gateway Health Plan

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Gateway Health Plan



Address: 600 Grant Street, 41st Floor Legal Entity Address: 600 Grant Street - 41st Floor



Contract Number: H5934 Legal Entity Name: HOPE HOSPICE AND COMMUNITY SERVICES, INC.

Organization Marketing Name: Hope Select Care Parent Organization: HOPE OF SOUTHWEST FLORIDA, INC.

National PACE Organization Type: Business Analyst Contact Title: National PACE Plan Type: Name: Ron Burris 3/1/2008 Contract Effective Date: 1-239-985-6400 Phone: Not-for-Profit/Non-Profit Tax Status: 76404Extension: Atlanta CMS Region Responsible: 1-239-985-6411 Fax:

Enrollment: 65 [email protected] Email: 2668 Winkler Ave. Address:

9470 HealthPark Circle Legal Entity Address: Ft. Myers City:

Fort Myers City: FLState: FLState: 33901Zip: 33908 Zip: 2/1/2008Last Updated:

Contract Number: H5938 Legal Entity Name: CAPITAL HEALTH PLAN

Organization Marketing Name: Capital Health Plan Parent Organization: Blue Cross and Blue Shield of Florida


2140 CENTERVILLE PLACE

TALLAHASSEE FL 32308




City: State:

Zip:


Enrollment: 9,131


Network Services Supervisor

1-850-523-7307


Tallahassee FL 32317 4/13/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Beth Maige



Organization Marketing Name: VillageHealth Parent Organization: SCAN Health Plan, Inc.

Organization Type: Demo Contact Title: Vice President, Marketing Plan Type: ESRD II - HMOPOS Name: Hans Eckardt



Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Airport Way Suite 100



Contract Number: H5948 Legal Entity Name: ARTA MEDICARE HEALTH PLAN, INC.

Organization Marketing Name: Arta Medicare Health Plan Parent Organization: ARTA MEDICARE HEALTH PLAN, INC.

Organization Type: Local CCP Contact Title: Vice President Operations Plan Type: HMO/HMOPOS Name: Karen Richmond



Address: 3333 Michelson Drive Suite 735 Legal Entity Address: 3333 Michelson Drive

Suite 735 City: Irvine City: Irvine State: CA








Contract Number: H5952 Legal Entity Name: CAMBRIDGE LIFE INSURANCE COMPANY


PFFS PFFS 1/1/2007

6705 Rockledge Drive Suite 900

Bethesda MD 20817

For Profit Denver



City: State:

Zip:


Enrollment: 1,299


Customer Service

1-866-386-2330

[email protected] Advantra Freedom/Coventry Health Care, Inc PO Box 7154 London KY 40742 2/28/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Advantra Freedom


STERLING LIFE INSURANCE COMPANY H5962


Fresenius Medical Care Health Plan, Inc. - Texas Organization Marketing Name: Munich American Holding Corporation Parent Organization: Demo ESRD I - PFFS 1/1/2006

2219 Rimland Drive PO Box 5348 Bellingham WA 982275348

For Profit Seattle



City: State:

Zip:


Enrollment: 157



1-360-647-9080 29073


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendi Western

ALOHACARE H5969


Organization Marketing Name: AlohaCare AlohaCareParent Organization: Local CCP HMO/HMOPOS 1/1/2006

1357 Kapiolani Blvd., Suite 1250

Honolulu HI 96814




City: State:

Zip:


Enrollment: 1,204


Customer Service Public Web Site Contact

1-866-973-6395

1-808-973-0726 [email protected] 1357 Kapiolani Blvd., Suite 1250

Honolulu HI 96814 11/20/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


PHI LIFE H5978


Organization Marketing Name: PHI LIFE dba everyday LIFE PHI LIFEParent Organization: National PACE National PACE 2/1/2009

One Trinity Dr. East Suite 201 Dillsburg PA 17019




City: State:

Zip:


Enrollment: *


Executive Director

1-484-895-4301

[email protected] 2045 Westgate Dr. Suite 100 Bethlehem PA 18017 12/18/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendy Weaver

FIDELIS SECURECARE OF TEXAS, INC. H5980


Organization Marketing Name: Fidelis SecureCare of Texas, Inc. Fidelis SecureCare Parent Organization: Local CCP HMO/HMOPOS 1/1/2007

17625 El Camino Real Suite 210 Houston TX 77058

For Profit Chicago



City: State:

Zip:


Enrollment: 202


Manager - Customer Services-Production

1-877-372-8085

[email protected] 201 Lackawanna Avenue

Scranton PA 18503 3/13/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Ron Rome


Contract Number: H5985 Legal Entity Name: ABRAZO ADVANTAGE HEALTH PLAN

Organization Marketing Name: Abrazo Advantage Health Plan Parent Organization: Vanguard Health Systems

Organization Type: Local CCP Contact Title: Director of Marketing Plan Type: HMO/HMOPOS Name: Myrna Chaydez



Address: 7878 N. 16th St. Legal Entity Address: 7878 N. 16th St. Suite 105

Suite 105 City: Phoenix City: Phoenix State: AZ


Contract Number: H5989 Legal Entity Name: COMPREHENSIVE CARE MANAGEMENT CORP.

Organization Marketing Name: Comprehensive Care Management Corp. Parent Organization: Bethco Corporation

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Felice Liburd Name: 1/1/2007 Contract Effective Date: 1-718-944-2106 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 20 [email protected] Email: 2275 Olinville Avenue Address:

612 Allerton Avenue Legal Entity Address: BronxCity:

Bronx City: NYState: NYState: 10467Zip: 10467 Zip: 3/17/2009Last Updated:

Contract Number: H5991 Legal Entity Name: AFFINITY HEALTH PLAN, INC.

Organization Marketing Name: Affinity Health Plan Parent Organization: Affinity Health Plan

Local CCP Organization Type: Director of Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Evelyn Rodriguez 1/1/2007 Contract Effective Date: 1-718-794-6228 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 1,739 [email protected] Email: 2500 Halsey Street Address:

2500 Halsey Street Legal Entity Address: BronxCity:

Bronx City: NYState: NYState: 10461Zip: 10461 Zip: 12/14/2007Last Updated:

Contract Number: H5992 Legal Entity Name: SENIOR WHOLE HEALTH, LLC

Organization Marketing Name: Senior Whole Health of New York Parent Organization: Senior Whole Health, LLC


58 Charles Street, 2nd Floor

Cambridge MA 02141

For Profit Boston



City: State:

Zip:


Enrollment: 700


VP, Information Technology

1-617-494-5353 6307 1-617-494-5599 [email protected] 58 Charles Street, 2nd Floor

Cambridge MA 02141 2/8/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Mike Levoshko


Contract Number: H5995 Legal Entity Name: MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC.

Organization Marketing Name: Marion Polk Community Health Plan Advantage, Inc. Parent Organization: Marion Polk Community Health Plan LLC

Local CCP Organization Type: Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2006 Contract Effective Date: 1-866-869-1514 Phone: For Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-503-566-9801 Fax:


245 Commercial St. SE, Ste. 200 Legal Entity Address: SalemCity:

Salem City: ORState: ORState: 97304Zip: 97301 Zip: 2/12/2009Last Updated:

Contract Number: H5996 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY, INC.

Organization Marketing Name: Health Net Pearl Parent Organization: Health Net, Inc.

PFFS Organization Type: Provider and Provider Directory Information Contact Title: PFFS Plan Type: Name: Member Services 1/1/2007 Contract Effective Date: 1-800-977-8221 Phone: For Profit Tax Status: Extension: Seattle CMS Region Responsible: Fax:

Enrollment: 12,838 [email protected] Email: 2019 Aerojet Rd., Mail Stop: CA-167-01-26 Address:

21650 Oxnard St Legal Entity Address: Rancho Cordova City:

Woodland HillsCity: CAState: CAState: 95742-6418 Zip: 91387 Zip: 3/14/2007Last Updated:



Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Medicare Member Services



Address: Unison Plaza Legal Entity Address: 890 Willow Tree Circle, Suite 10 1001 Brinton Road

City: Pittsburgh City: Cordova State: PA



Organization Marketing Name: HISC - Blue Cross Blue Shield of IL, NM, OK & TX Parent Organization: Health Care Service Corporation

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Brenda Hightower


CMS Region Responsible: Dallas Fax: 1-972-766-0342 Enrollment: * Email: [email protected]

Address: Blue Cross Blue Shield of Texas Legal Entity Address: 901 South Central Expressway, North Building 901 S. Central Expressway

City: Richardson City: Richardson State: TX




Legal Entity Name: KAISER FOUNDATION HP, INC.Organization Marketing Name: Kaiser Permanente Medicare Cost

Parent Organization: Kaiser Foundation Health Plan, Inc.1876 Cost Organization Type: Contact Title: 1876 Cost Plan Type: Name: Member Services 1/1/1987 Contract Effective Date: 1-800-443-0815 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 1,193 [email protected] Email: 393 E Walnut St Fl 7Address:

P.O.BOX 12916 Legal Entity Address: Pasadena City:



Organization Marketing Name: Kaiser Permanente Medicare Cost Parent Organization: Kaiser Foundation Health Plan, Inc.

1876 Cost Organization Type: Contact Title: 1876 Cost Plan Type: Name: Member Services 1/1/1987 Contract Effective Date: 1-800-443-0815 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 4,140 [email protected] Email: 393 E Walnut St Fl 7Address:

ONE KAISER PLAZA Legal Entity Address: Pasadena City:


Contract Number: H6053 Legal Entity Name: SANTE FE EMPLOYEES HOSPITAL ASSN.

Organization Marketing Name: Santa Fe Employes Hospital Assn. - Coast Lines Parent Organization: Sante Fe Employees Hospital Assn.

Organization Type: HCPP - 1833 Cost Contact Title: Business Manager / Controller Plan Type: HCPP - 1833 Cost Name: Myrna L Montana



Address: 551 e. San Bernardino Road, Legal Entity Address: 551 E. SAN BERNARDINO ROAD

City: Covina City: COVINA State: CA


Contract Number: H6120 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF FLORIDA

Organization Marketing Name: PHYSICIANS HEALTH CHOICE Parent Organization: PSO Health Services, LLC




Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 FREDERICKSBURG ROAD SUITE 360

City: San Antonio City: SAN ANTONIO State: TX



Contract Number: H6140 Legal Entity Name: WABASH MEM. HOSPITAL

Organization Marketing Name: Wabash Mem. Hospital Parent Organization: Wabash Memorial Hospital Association

HCPP - 1833 Cost Organization Type: Admin.Contact Title: HCPP - 1833 Cost Plan Type: Name: Tamara Bivins 1/1/1987 Contract Effective Date: 1-217-429-5246 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-217-542-0134 Fax:

Enrollment: 1,784 [email protected] Email: 1340 N. Water St Address:

1501 NORTH WATER ST. Legal Entity Address: PO Box 1340 DecaturCity:

DECATUR City: ILState: ILState: 62526Zip: 62526 Zip: 6/2/2008Last Updated:

Contract Number: H6141 Legal Entity Name: SIDNEY HILLMAN HC

Organization Marketing Name: Sidney Hillman HC Parent Organization: Sidney Hillman Health Center (SHHC)

HCPP - 1833 Cost Organization Type: No contact data submitted Contact Title: HCPP - 1833 Cost Plan Type: Name: 2/1/1983 Contract Effective Date: Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 955 Email: Address:

333 SOUTH ASHLAND AVENUE Legal Entity Address: City:

CHICAGO City: State: ILState: Zip: 606072750 Zip: Last Updated:

Contract Number: H6142 Legal Entity Name: UNION HEALTH SERVICES, INC.

Organization Marketing Name: Union Health Service, Inc. Parent Organization: Union Health Services, Inc.

HCPP - 1833 Cost Organization Type: No contact data submitted Contact Title: HCPP - 1833 Cost Plan Type: Name: 2/1/1983 Contract Effective Date: Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 1,485 Email: Address:

1634 WEST POLK STREET Legal Entity Address: City:

CHICAGO City: State: ILState: Zip: 60612 Zip: Last Updated:

Contract Number: H6143 Legal Entity Name: UNION MEDICAL CENTER

Organization Marketing Name: Union Medical Center Parent Organization: Union Medical Center

HCPP - 1833 Cost HCPP - 1833 Cost 2/1/1983

1657 WEST ADAMS STREET

CHICAGO IL 60612




City: State:

Zip:


Enrollment: 773


No contact data submitted Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name:


DAVITA VILLAGEHEALTH OF GEORGIA, INC. H6145


Organization Marketing Name: DaVita VillageHealth of Georgia, Inc. Davita IncParent Organization: Local CCP Local PPO 1/1/2008

Sr Manager, Marketing Operations and Communication

1-303-626-6247

1-303-626-6384 [email protected] 1627 Cole Blvd

Lakewood CO 80401 1/14/2008

Three Hawthorn Parkway Suite 410 Vernon Hills IL 60061

For Profit Denver



Contact Title:

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Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Name: Teri Hunt

100


CARESOURCE H6178


Organization Marketing Name: CareSource CareSourceParent Organization: Local CCP HMO/HMOPOS 1/1/2008

Director of Communications

1-937-224-3300 2910 1-937-425-0864 [email protected] P. O. Box 8738

Dayton OH 45401 3/4/2009

One Dayton Centre, 20th Floor One South Main Street Dayton OH 45402




Contact Title:

Phone: Extension:

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Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Name: Michelle Chapman

314


AMERIGROUP NEW YORK, LLC H6181


Organization Marketing Name: AMERIGROUP Community Care AMERIGROUP Corporation Parent Organization: Local CCP HMO/HMOPOS 1/1/2008 1-866-805-4589

[email protected] AMERIGROUP Corporation 4425 Corporation Lane Virginia Beach VA 23462 2/3/2009

360 West 31st Street, Fifth Floor

New York NY 10001

For Profit New York



Contact Title:

Phone: Extension:

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Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Dedicated Services UnitName:

507


COMPCARE HEALTH SERVICES INSURANCE CORPORATION H6184


Anthem Blue Cross and Blue ShieldOrganization Marketing Name: Wellpoint, Inc. Parent Organization: Local CCP HMO/HMOPOS 1/1/2008 1-800-467-1199

[email protected] 4241 Irwin Simpson Road

Mason OH 45040 7/13/2007

1 WellPoint Way CAT201-C004 Thousand Oaks CA 90362

For Profit Chicago



Contact Title:

Phone: Extension:

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Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:


57







9900 Bren Road East Legal Entity Address: CA124-0142 Mail Route MN-008-W140 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: H6231 Legal Entity Name: FRANCISCAN PACE, INC.

Organization Marketing Name: PACE Baton Rouge Parent Organization: Franciscan PACE, Inc.

National PACE Organization Type: Executive Director Contact Title: National PACE Plan Type: Name: Karen Allen 7/1/2008 Contract Effective Date: 1-225-490-0322 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-225-490-0354 Fax:

Enrollment: 44 [email protected] Email: 7436 Bishop Ott Drive Address:

7436 Bishop Ott Drive Legal Entity Address: Baton Rouge City:

Baton Rouge City: LAState: LAState: 70806Zip: 70808 Zip: 3/13/2009Last Updated:

Contract Number: H6264 Legal Entity Name: HEALTHPLUS PHSP, INC.

Organization Marketing Name: Health Plus Elite Parent Organization: Lutheran Medical Center

Local CCP Organization Type: VP, Network Management Contact Title: HMO/HMOPOS Plan Type: Name: Cleo Dixon 1/1/2009 Contract Effective Date: 1-718-491-6770 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-718-504-9676 Fax:

Enrollment: 265 [email protected] Email: 335 Adams Street Address:

335 Adams Street, 26 Floor Legal Entity Address: 26th Floor BrooklynCity:

BrooklynCity: NYState: NYState: 11201Zip: 11201 Zip: 3/4/2008Last Updated:

Contract Number: H6328 Legal Entity Name: CARE N' CARE INSURANCE COMPANY, INC.

Organization Marketing Name: Care N' Care Health Plan Parent Organization: North Texas Specialty Physicians


1701 River Run Suite 402 Fort Worth TX 76107

For Profit Dallas



City: State:

Zip:


Enrollment: 405


Chief Operating Officer

1-817-529-9234

1-817-332-3614 [email protected] 1701 River Run Suite 402 Fort Worth TX 76107 4/15/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Brad Larson


Contract Number: H6331 Legal Entity Name: BORO MEDICAL CENTER

Organization Marketing Name: Boro Medical, P.C. Parent Organization: Boro Medical Center

HCPP - 1833 Cost Organization Type: Contact Title: HCPP - 1833 Cost Plan Type: Name: Cinthya Vargas 1/1/1987 Contract Effective Date: 1-718-423-0808 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 1,722 [email protected] Email: 22-02 Steinway Street Address:

22-02 Steinway Street Legal Entity Address: AstoriaCity:

AstoriaCity: NYState: NYState: 11105Zip: 11105 Zip: 8/31/2007Last Updated:

Contract Number: H6334 Legal Entity Name: NY HOTEL TRADES COUNCIL and HOTEL ASSN OF NYC

Organization Marketing Name: NY Hotel Trades Council and Hotel Assn. of NYC Parent Organization: NY Hotel Trades Council&Hotel Assn of NYC

Organization Type: HCPP - 1833 Cost Contact Title: Compliance Officer, Government Programs Plan Type: HCPP - 1833 Cost Name: Jordan Beasley



Address: 305 West 44th Street Legal Entity Address: 305 WEST 44TH STREET



Contract Number: H6360 Legal Entity Name: KAISER FOUNDATION HP OF OHIO

Organization Marketing Name: Kaiser Permanente Medicare Plus Parent Organization: Kaiser Foundation Health Plan, Inc.

Organization Type: 1876 Cost Contact Title: Department Plan Type: 1876 Cost Name: Customer Relations



Address: 5500 Lancaster Drive Legal Entity Address: North Point Tower, Suite 1200

1001 Lakeside Avenue City: Brooklyn Heights City: CLEVELAND State: OH











Contract Number: H6421 Legal Entity Name: BRAVO HEALTH MID- ATLANTIC INC.








Contract Number: H6499 Legal Entity Name: WELLCARE HEALTH INSURANCE OF NEW YORK, INC.


PFFS Organization Type: Plan Directory Contact Contact Title: PFFS Plan Type: Name: Mary Solomon 1/1/2007 Contract Effective Date: 1-888-888-9355 Phone: For Profit Tax Status: 3091Extension: Atlanta CMS Region Responsible: Fax:


8735 Henderson Rd Ren 2 Legal Entity Address: TampaCity:


Contract Number: H6504 Legal Entity Name: CONNECTICARE INSURANCE COMPANY, INC.

Organization Marketing Name: ConnectiCare Insurance Company, Inc. Parent Organization: EmblemHealth Inc.

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Jennifer Bauer



Address: 175 Scott Swamp Road Legal Entity Address: 175 Scott Swamp Road

City: Farmington City: Farmington State: CT


Contract Number: H6528 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.

Organization Marketing Name: Care Improvement PPO Parent Organization: XLHealth Corporation


351 West Camden Street Suite 100 Baltimore MD 212012473




City: State:

Zip:


Enrollment: *


Marketing Manager

1-410-625-2200


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Misty Smith


Contract Number: H6621 Legal Entity Name: THP INSURANCE COMPANY

Organization Marketing Name: Health Plan SecureFreedom Parent Organization: Health Plan of the Upper Ohio Valley

PFFS Organization Type: Director Member Services Contact Title: PFFS Plan Type: Name: Sherry Stanley 1/1/2008 Contract Effective Date: 1-740-695-7682 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-740-695-8103 Fax:

Enrollment: 42 [email protected] Email: The Health Plan Address:










Organization Type: PFFS Contact Title: Sales Manager Medicare Plan Type: PFFS Name: Catherine Mercury



Address: 220 Alexander St Legal Entity Address: 220 Alexander St.

City: Rochester City: Rochester State: NY


Contract Number: H6864 Legal Entity Name: GUILDNET, INC.

Organization Marketing Name: GuildNet Parent Organization: Guildnet, Inc.


15 WEST 65TH STREET

NEW YORK NY 10023




City: State:

Zip:


Enrollment: 145


VP, Medicare Services

1-917-386-9129

1-212-769-1621 [email protected] 15 West 65th Street

New York NY 10023 7/8/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Toni Cassetta








Contract Number: H6923 Legal Entity Name: AETNA HEALTH






Contract Number: H6934 Legal Entity Name: UAHC HEALTH PLAN OF TENNESSEE, INC.

Organization Marketing Name: UAHC Gold Parent Organization: UAHC HEALTH PLAN OF TENNESSEE

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Nicole Gibson 1/1/2007 Contract Effective Date: 1-901-348-2205 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-901-346-1032 Fax:

Enrollment: 624 [email protected] Email: 6555 Quince RoadAddress:

1769 Paragon Drive, Suite 100 Legal Entity Address: Suite 300A MemphisCity:

Memphis City: TNState: TNState: 38115Zip: 38132 Zip: 5/27/2009Last Updated:







City:State:

Zip:

H6952 GREAT LAKES HEALTH PLAN, INC. Great Lakes Personal Care Plus UnitedHealth Group, Inc. Local CCP HMO/HMOPOS 1/1/2008 For Profit San Francisco 397

17117 W. Nine Mile Road Suite 1600 Southfield MI 48075

Contact Title:Name:

Phone:Extension:

Fax:Email:

Address:

City:State:

Zip:Last Updated:

Provider Services Dawnyalle Gillis 1-248-331-4296

1-248-559-4640 [email protected] 17117 W. Nine Mile Rd. Ste 1600

Southfield MI 48075 11/20/2008







Depere City: KYState: WIState: 40202Zip: 54115 Zip: 2/8/2008Last Updated:

Contract Number: H7015 Legal Entity Name: HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC.

Organization Marketing Name: Healthfirst NJ Parent Organization: Healthfirst Management Services, LLC.

Local CCP Organization Type: Healthfirst Medicare PlanContact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2008 Contract Effective Date: 1-888-801-1660 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 2,855 [email protected] Email: 25 Broadway Address:

25 Broadway Legal Entity Address: 9th Floor 9th Floor New York City: New York City: NYState: NYState: 10004Zip: 10004 Zip: 4/9/2008Last Updated:

Contract Number: H7086 Legal Entity Name: COMMUNITY HEALTH GROUP

Organization Marketing Name: Community Health Group Parent Organization: Community Health Group

Local CCP Organization Type: Chief Information Officer Contact Title: HMO/HMOPOS Plan Type: Name: Jonathan Tamayo 1/1/2008 Contract Effective Date: 1-619-498-6597 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-619-476-3818 Fax:

Enrollment: 554 [email protected] Email: 740 Bay Blvd.Address:

740 BAY BOULEVARD Legal Entity Address: Chula VistaCity:

CHULA VISTA City: CAState: CAState: 91910-5254 Zip: 91910 Zip: 3/6/2007Last Updated:

Contract Number: H7146 Legal Entity Name: MD CARE, INC.

Organization Marketing Name: San Miguel Health Plan Parent Organization: MD Care, Inc.


100 West Broadway Suite 4000 Long Beach CA 90802




City: State:

Zip:


Enrollment: 877


Manager, Member Services

1-562-344-3431

1-562-344-3321 [email protected] 10941 Bloomfield Street Suite F Los Alamitos CA 90720 12/11/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Angie Garcia


Contract Number: H7149 Legal Entity Name: COVENTRY HEALTH CARE OF NEBRASKA, INC.

Organization Marketing Name: Coventry Health Care of Nebraska Advantra Parent Organization: Coventry Health Care Inc.




Address: 3721 TecPort Drive, PO 67103 Legal Entity Address: 13305 Birch Drive

Suite 100 City: Harrisburg City: Omaha State: PA

State: NE Zip: 17106 Zip: 68164 Last Updated: 7/3/2007

Contract Number: H7179 Legal Entity Name: ARCADIAN HEALTH PLAN OF LOUISIANA, INC.

Organization Marketing Name: Arcadian Community Care Parent Organization: Arcadian Management Services Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/2008 Contract Effective Date: 1-800-573-8597 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:


825 Washington Street, Suite 300 Legal Entity Address: OaklandCity:

OaklandCity: CAState: CAState: 94607Zip: 94607 Zip: 2/28/2008Last Updated:






Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Rd East CA124-0142












Contract Number: H7195 Legal Entity Name: NORTHLAND PACE PROGRAM

Organization Marketing Name: Northland PACE Program Parent Organization: Northland Healthcare Alliance

National PACE Organization Type: Contact Title: National PACE Plan Type: Name: Laurie Peters 8/1/2008 Contract Effective Date: 1-701-748-3485 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 16 [email protected] Email: 201 North 24th Street Address:

201 North 24th Street Legal Entity Address: Bismarck City:

Bismarck City: NDState: NDState: 58501Zip: 58501 Zip: 5/18/2009Last Updated:

Contract Number: H7200 Legal Entity Name: AMERIGROUP TENNESSEE, INC.



Enrollment: 860 [email protected] Email: AMERIGROUP Corporation Address:

Three Lakeview Place Legal Entity Address: 4425 Corporation Lane 22 Century Blvd., Suite 310 Virginia Beach City: Nashville City: VAState: TNState: 23462Zip: 37214 Zip: 2/3/2009Last Updated:

Contract Number: H7206 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE CO

Organization Marketing Name: Advantra« Savings Parent Organization: Coventry Health Care Inc.

MSA Organization Type: Customer Service Contact Title: MSA Plan Type: Name: Advantra Savings 1/1/2008 Contract Effective Date: 1-877-359-5331 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 2,988 [email protected] Email: P.O Box 7154 Address:

6705 ROCKLEDGE DRIVE Legal Entity Address: SUITE 900 LondonCity: BETHESDA City: KYState: MDState: 40742Zip: 20817 Zip: 2/11/2008Last Updated:

Contract Number: H7220 Legal Entity Name: CLARIAN HEALTH PLANS, INC.

Organization Marketing Name: Clarian Health Plans, Inc. - Clarian Medicare Parent Organization: Clarian Health Partners, Inc.

Organization Type: Local CCP Contact Title: Customer Solutions Center Manager Plan Type: HMO/HMOPOS Name: Trina Gibson



Address: 1776 N. Meridian Street Legal Entity Address: 1776 N. Meridian Street, Suite 300 Suite 300

City: Indianapolis City: Indianapolis State: IN

State: IN Zip: 46202 Zip: 46202 Last Updated: 2/23/2009


Contract Number: H7226 Legal Entity Name: HARVARD PILGRIM HEALTH CARE INC.

Organization Marketing Name: HARVARD PILGRIM HEALTH CARE INC. Parent Organization: Harvard Pilgrim Health Care

Organization Type: PFFS Contact Title: Medicare Compliance Officer Plan Type: PFFS Name: Michael J Comerford


CMS Region Responsible: Boston Fax: 1-617-509-2257 Enrollment: 27,172 Email: [email protected]

Address: 1600 Crown Colony Drive Legal Entity Address: 93 Wocester Street

City: Quincy City: Wellesley State: MA


Contract Number: H7252 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF ARKANSAS

Organization Marketing Name: Physicians Health Choice Parent Organization: PSO Health Services, LLC

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 1/1/2009 Contract Effective Date: 1-866-550-4736 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 332 [email protected] Email: 5800 Northwest Parkway Suite 125 Address:

8637 FREDERICKBURG ROAD SUITE 360Legal Entity Address: San Antonio City:

SAN ANTONIO City: TXState: TXState: 78249Zip: 78240 Zip: 8/18/2008Last Updated:

Contract Number: H7292 Legal Entity Name: ALAMEDA ALLIANCE JOINT POWERS AUTHORITY (JPA)

Organization Marketing Name: Alliance for Health Parent Organization: Alameda Alliance for Health

Organization Type: Local CCP Contact Title: Medicare Compliance Coordinator Plan Type: HMO/HMOPOS Name: Suzanne Tsang



Address: 1240 South Loop Road Legal Entity Address: 1240 South Loop Road

City: Alameda City: Alameda State: CA


Contract Number: H7301 Legal Entity Name: PERSONAL CARE INSURANCE OF ILLINOIS

Organization Marketing Name: PersonalCare Advantra Parent Organization: Coventry Health Care Inc.


2110 Fox Drive, Ste. A

Champaign IL 61820

For Profit Denver



City: State:

Zip:


Enrollment: 1,189


Director, Medicare/Individual

1-217-366-5708

1-217-366-5410 [email protected] 2110 Fox Dr

Champaign IL 61820 3/5/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Carol A Baker


Contract Number: H7306 Legal Entity Name: FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY

Organization Marketing Name: Coventry Advantra Parent Organization: Coventry Health Care Inc.




Address: 3721 TecProt Dr Legal Entity Address: 6705 Rockledge Drive

Suite 900 City: Harrisburg City: Bethesda State: PA


Contract Number: H7352 Legal Entity Name: UPH/MIHS VENTURES L.L.C.

Organization Marketing Name: University Physicians/Maricopa Care Advantage Parent Organization: UPH/MIHS Ventures, L.L.C.

Organization Type: Local CCP Contact Title: Sales and Marketing Manager Plan Type: HMO/HMOPOS Name: April Forman



Address: 2701 E. Elvira Legal Entity Address: 2701 E. Elvira

City: Tucson City: Tucson State: AZ


Contract Number: H7406 Legal Entity Name: BRAVO HEALTH INSURANCE COMPANY, INC.








Contract Number: H7475 Legal Entity Name: CARE WISCONSIN HEALTH PLAN, INC.

Organization Marketing Name: Care Wisconsin Health Plan, Inc. Parent Organization: Care Wisconsin First, Inc.




Address: 2802 International Lane Legal Entity Address: 2802 International Lane P.O. Box 14017

PO Box 14017 City: Madison City: Madison State: WI

State: WI Zip: 53708-0017 Zip: 537080017 Last Updated: 4/30/2009


Contract Number: H7526 Legal Entity Name: MEDICA HEALTH PLAN

Organization Marketing Name: Medica Health Plans Parent Organization: Medica Health Plans





City: Minnetonka City: Minnetonka State: MN


Contract Number: H7568 Legal Entity Name: DAVITA VILLAGEHEALTH OF OHIO, INC.

Organization Marketing Name: DaVita VillageHealth of Ohio, Inc. Parent Organization: Davita Inc




Contract Number: H7660 Legal Entity Name: LUTHERAN SENIORLIFE LIFE-BEAVER COUNTY

Organization Marketing Name: LIFE-Beaver County Parent Organization: Lutheran SeniorLife

Organization Type: National PACE Contact Title: Director of Reimbursment Plan Type: National PACE Name: Katie Schick



Address: Lutheran SeniorLife Legal Entity Address: 1323 Freedom Road 1323 Freedom Road

City: Cranberry Township City: Cranberry Twp. State: PA


Contract Number: H7678 Legal Entity Name: MOLINA HEALTHCARE OF TEXAS, INC.

Organization Marketing Name: Molina Healthcare of Texas, Inc. Parent Organization: Molina Healthcare, Inc.,


2505 North Hwy 360, Suite 300

Grand Prairie TX 75050

For Profit Denver



City: State:

Zip:


Enrollment: 404


Vice President

1-562-901-1080


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H7692 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY




CMS Region Responsible: Denver Fax: Enrollment: 624 Email: [email protected]

Address: 3721 TecPort Dr Legal Entity Address: 6705 Rockledge Drive

Suite 900 City: Harrisburg City: Bethesda State: PA


Contract Number: H7731 Legal Entity Name: MD CARE, INC.

Organization Marketing Name: MD Care Inc Parent Organization: MD Care, Inc.

Organization Type: Local CCP Contact Title: Director, Administrative Services Plan Type: HMO/HMOPOS Name: Gabriel Viola



Address: 1640 E Hill Street Legal Entity Address: 10941 Bloomfield Street

Suite F City: Signal Hill City: Los Alamitos State: CA


Contract Number: H7787 Legal Entity Name: HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.

Organization Marketing Name: HealthSpring Medicare Advantage Parent Organization: HealthSpring, Inc.


2900 North Loop West Suite 300 Houston TX 77092

For Profit Denver



City: State:

Zip:


Enrollment: 1,553


AETNA HEALTH H7908


Organization Marketing Name: Aetna Medicare Aetna Inc.Parent Organization: Local CCP HMO/HMOPOS 1/1/2008

980 Jolly Road

Blue Bell PA 19422

For Profit Boston



City: State:

Zip:


Enrollment: 700


Vice President of Customer Service

1-832-553-3300 3379 1-832-553-3400 [email protected] 2900 North Loop West Suite 1300

Houston TX 77092 2/5/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendy Wetzel

1-800-445-1796

[email protected] 151 Farmington Avenue

Hartford CT 06156 12/11/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Aetna Customer Service


Contract Number: H7917 Legal Entity Name: BLUE CROSS BLUE SHIELD OF TENNESSEE


Local CCP Organization Type: Supervisor Medicare Advantage Operations Contact Title: Local PPO Plan Type: Name: Carol Troxell 1/1/2008 Contract Effective Date: 1-800-841-7434 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: Fax:




Contract Number: H7949 Legal Entity Name: PACIFICARE OF NEVADA, INC.

Organization Marketing Name: Pacificare/UHC of Nevada Parent Organization: UnitedHealth Group, Inc.




Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Rd E CA124-0142



Contract Number: H7981 Legal Entity Name: MCS LIFE INSURANCE COMPANY


PFFS Organization Type: VP A- Medicare Compliance Contact Title: PFFS Plan Type: Name: Carlos J Fournier 1/1/2007 Contract Effective Date: 1-787-758-2500 Phone: For Profit Tax Status: 4547Extension: New York CMS Region Responsible: 1-787-620-6906 Fax:

Enrollment: * [email protected] Email: MCS PlazaAddress:

255 Ponce De Leon Ave, Suite 201 Legal Entity Address: 255 Ponce de Leon Avenue, Second Floor San JuanCity:

San Juan City: PRState: PRState: 00918Zip: 009171919 Zip: 3/6/2009Last Updated:

Contract Number: H8031 Legal Entity Name: GATEWAY HEALTH PLAN OF OHIO, INC.

Organization Marketing Name: Gateway Health Plan Medicare Assured Parent Organization: Gateway Health Plan

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Gateway Health Plan



Address: 600 Grant Street, 41st Floor Legal Entity Address: 600 Grant Street- 41st Floor





Legal Entity Name: CENTRA HEALTH, INC.Organization Marketing Name: Centra PACE

Parent Organization: Centra Health, Inc.Organization Type: National PACE Contact Title: Centra PACE Program Director

Plan Type: National PACE Name: Debra M Maddox Contract Effective Date: 2/1/2009 Phone: 1-434-200-4190

Tax Status: Not-for-Profit/Non-Profit Extension: CMS Region Responsible: Philadelphia Fax:

Enrollment: 11 Email: [email protected] Address: 407 Federal Street

Legal Entity Address: 407 Federal Street City: Lynchburg

City: Lynchburg State: VA State: VA Zip: 24504

Zip: 24504 Last Updated: 8/25/2008 Contract Number: H8172 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY








Contract Number: H8189 Legal Entity Name: MANAGED HEALTH SERVICES, WISCONSIN

Organization Marketing Name: Advantage by Managed Health Services Parent Organization: Centene Corporation

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Sandi TunisName: 1/1/2008 Contract Effective Date: 1-414-773-4000 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: Fax:

Enrollment: * [email protected] Email: 10700 West Research Drive Address:

10700 West Research Drive Legal Entity Address: Suite 300 Suite 300 MilwaukeeCity: Milwaukee City: WIState: WIState: 53226Zip: 53226 Zip: 6/23/2008Last Updated:

Contract Number: H8239 Legal Entity Name: FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY





Address: 3721 TecPort Dr Legal Entity Address: 6710 Rockledge Drive

City: Harrisburg City: Bethesda State: PA



Contract Number: H8393 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE CO. (NEBRASKA)





Address: 3721 TecPort Drive, PO 67103 Legal Entity Address: 13305 Birch Drive

Suite 100 City: Harrisburg City: Omaha State: PA

State: NE Zip: 17106 Zip: 68164 Last Updated: 4/9/2008

Contract Number: H8424 Legal Entity Name: SIOUXLAND PACE, INC.

Organization Marketing Name: SIOUXLAND PACE, INC. Parent Organization: Siouxland PACE, Inc.

National PACE Organization Type: DirectorContact Title: National PACE Plan Type: Name: Linda D Todd 8/1/2008 Contract Effective Date: 1-712-233-4105 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Kansas CityCMS Region Responsible: 1-712-233-1123 Fax:

Enrollment: 33 [email protected]: 4300 Hamilton BlvdAddress:

4300 Hamilton Blvd Legal Entity Address: Sioux CityCity:

Sioux City City: IAState: IAState: 51104Zip: 51104 Zip: 1/22/2008Last Updated:

Contract Number: H8468 Legal Entity Name: GEISINGER INDEMNITY INSURANCE COMPANY


MSA Organization Type: Director of Customer Service Contact Title: MSA Plan Type: Renee BlasiName: 1/1/2008 Contract Effective Date: 1-800-498-9731 Phone: For Profit Tax Status: 16159Extension: Denver CMS Region Responsible: 1-570-271-5970 Fax:

Enrollment: 405 [email protected] Email: 100 North Academy Avenue Address:

100 North Academy Avenue Legal Entity Address: DanvilleCity:

Danville City: PAState: PAState: 17822-3229 Zip: 178223220 Zip: 12/14/2007Last Updated:

Contract Number: H8578 Legal Entity Name: HEALTH NEW ENGLAND, INC.

Organization Marketing Name: Health New England, Inc. Parent Organization: Baystate Health, Inc.


One Monarch Place Suite 1500 Springfield MA 01144

For Profit Boston



City: State:

Zip:


Enrollment: 345


Communications Manager

1-413-787-4000 3229 1-413-734-3356 [email protected] Health New England, Inc. One Monarch Place, Suite 1500 Springfield MA 01144 2/14/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Joseph Kane


Contract Number: H8604 Legal Entity Name: THP INSURANCE COMPANY

Organization Marketing Name: Health Plan SecureChoice Parent Organization: Health Plan of the Upper Ohio Valley

Local CCP Organization Type: Director Member Services Contact Title: Local PPO Plan Type: Name: Sherry Stanley 1/1/2008 Contract Effective Date: 1-740-695-7682 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-740-695-8103 Fax:

Enrollment: 281 [email protected] Email: The Health Plan Address:









Contract Number: H8649 Legal Entity Name: ALTIUS HEALTH PLANS, INC. (UTAH)

Organization Marketing Name: Altius Advantra Parent Organization: Coventry Health Care Inc.

Local CCP Organization Type: Director, Medicare Product Contact Title: HMO/HMOPOS Plan Type: Name: Jamie Moser 1/1/2008 Contract Effective Date: 1-801-933-3561 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: 1-801-323-6100 Fax:

Enrollment: 4,796 [email protected] Email: 10421 South Jordan Gateway Address:

10421 South Jordan Gateway Legal Entity Address: Suite 400 Suite 400 South Jordan City: South Jordan City: UTState: UTState: 84095Zip: 84095 Zip: 12/24/2007Last Updated:

Contract Number: H8655 Legal Entity Name: RIVERSIDE RETIREMENT SERVICES, INC.

Organization Marketing Name: Riverside PACE Parent Organization: Riverside Retirement Services, Inc.


1020 Old Denbigh Blvd.

Newport News VA 23602




City: State:

Zip:


Enrollment: 129


Marketing Manager

1-757-251-7997

[email protected] 4107 W Mercury Blvd

Hampton VA 23666 4/16/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Donna FitzgeraldName:








Contract Number: H8742 Legal Entity Name: ABRI HEALTH PLAN, INC

Organization Marketing Name: Universal American Parent Organization: ABRI Health Plan, Inc.





Suite 800 City: Houston City: Houston State: TX






c/o UnitedHealth Group/Ovations, 9900 Bren Rd East Legal Entity Address: CA124-0142 MAIL ROUTE MN0008-W240 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:




12655 Olive Boulevard 4th Floor St. Louis MO 63141




City: State:

Zip:


Enrollment: 4,411


Director, Claims and Customer Service

1-314-851-3600

[email protected] 12655

St. Louis MO 63141 1/27/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Dawn Walter


Contract Number: H8800 Legal Entity Name: TOTAL SENIOR CARE, INC.

Organization Marketing Name: Total Senior Care, Inc. Parent Organization: TOTAL SENIOR CARE, INC.

Organization Type: National PACE Contact Title: Program Officer Plan Type: National PACE Name: Ann Feightner



Address: 519 North Union Street Legal Entity Address: 519 North Union Street

City: Olean City: Olean State: NY


Contract Number: H8805 Legal Entity Name: ELDERPLAN, INC.

Organization Marketing Name: Elderplan, Inc. Parent Organization: Elderplan, Inc.

Local CCP Organization Type: AVP Sales Admin., Informatics and Customer Service Contact Title: Local PPO Plan Type: Name: Lois Faust 1/1/2009 Contract Effective Date: 1-718-759-4080 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-718-921-8824 Fax:

Enrollment: * [email protected] Email: 6323 Seventh Avenue Address:

6323 Seventh Avenue Legal Entity Address: BrooklynCity:

BrooklynCity: NYState: NYState: 11220Zip: 11220 Zip: 2/20/2008Last Updated:

Contract Number: H8822 Legal Entity Name: ADVANTAGE HEALTH SOLUTIONS, INC.

Organization Marketing Name: ADVANTAGE Health Solutions, Inc. Parent Organization: Advantage Health Solutions

Local CCP Organization Type: Manager of Marketing and Enrollment Strategies Contact Title: HMO/HMOPOS Plan Type: Name: Cynthia Stepp 1/1/2009 Contract Effective Date: 1-317-573-7954 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 203 [email protected] Email: 9045 River Road, Suite 200 Address:

9045 River Road, Suite 200 Legal Entity Address: Indianapolis City:

Indianapolis City: INState: INState: 46240Zip: 46240 Zip: 7/21/2008Last Updated:

Contract Number: H8836 Legal Entity Name: MENNONITE MUTUAL AID ASSOCIATION

Organization Marketing Name: Mennonite Mutual Aid Association Parent Organization: Mennonite Mutual Aid Association

RFB - PFFS RFB PFFS 1/1/2008

1110 N. Main Street PO Box 483 Goshen IN 46527




City: State:

Zip:


Enrollment: 152



1-360-392-9073 29073 1-360-392-9100 [email protected] 2219 Rimland Drive PO Box 5348 Bellingham WA 98227-5348 1/14/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendi Western




Organization Type: Local CCP Contact Title: Director, Regulatory Compliance Plan Type: Local PPO Name: Barbara Sellman



Address: 11 Stanwix Street Legal Entity Address: 3721 TecPort Drive Suite 2300

City: Pittsburgh City: Harrisburg State: PA


Contract Number: H8991 Legal Entity Name: AMERIGROUP FLORIDA, INC.



Enrollment: 1,463 [email protected] Email: AMERIGROUP Corporation Address:

4200 W. Cypress Street, Suite 900 Legal Entity Address: 4425 Corporation Lane Virginia Beach City:

Tampa City: VAState: FLState: 23462Zip: 33607 Zip: 2/3/2009Last Updated:


Organization Marketing Name: Fallon Community Health Plan Parent Organization: Fallon Community Health Plan

Organization Type: Local CCP Contact Title: Sr. Manager Medicare Programs Plan Type: HMO/HMOPOS Name: Lisa Lashbrook



Address: One Chestnut Place Legal Entity Address: ONE CHESTNUT PLACE 10 Chestnut Street

10 CHESTNUT STREET City: Worcester City: WORCESTER State: MA


Contract Number: H9003 Legal Entity Name: KAISER FOUNDATION HP OF THE N W

Organization Marketing Name: Kaiser Permanente Parent Organization: Kaiser Foundation Health Plan, Inc.




Address: 500 NE Multnomah St.,Suite 100 Legal Entity Address: 500 NE Multnomah St

SUITE 100 City: Portland City: PORTLAND State: OR



Contract Number: H9005 Legal Entity Name: HEALTHPARTNERS, INC.

Organization Marketing Name: HealthPartners Classic Plan Parent Organization: HealthPartners, Inc.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Provider Services



Address: 8170 33rd Avenue South Legal Entity Address: 8170 33rd AVENUE SOUTH PO Box 1309

PO BOX 1309 City: Minneapolis City: Minneapolis State: MN


Contract Number: H9011 Legal Entity Name: UNITEDHEALTHCARE OF FLORIDA, INC.




13621 N.W. 12TH ST. Legal Entity Address: CA124-0142 CyressCity:

SUNRISE City: CAState: FLState: 90630Zip: 33323 Zip: 4/14/2009Last Updated:

Contract Number: H9047 Legal Entity Name: PROVIDENCE HEALTH PLAN

Organization Marketing Name: Providence Health Plan Parent Organization: Providence Health System

Organization Type: Local CCP Contact Title: Medicare Compliance Coordinator Plan Type: HMO/HMOPOS Name: Keri Steege



Address: 3601 SW Murray Blvd. Legal Entity Address: 3601 SW MURRAY BLVD. Suite 10

SUITE 10 City: Beaverton City: BEAVERTON State: OR


Contract Number: H9082 Legal Entity Name: MOLINA HEALTHCARE OF NEW MEXICO, INC.

Organization Marketing Name: Molina Healthcare of New Mexico, Inc. Parent Organization: Molina Healthcare, Inc.,


8801 Horizons Blvd., Suite 400

Albuquerque NM 87113

For Profit Denver



City: State:

Zip:


Enrollment: 383


Vice President

1-562-901-1080


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:




Legal Entity Name: ELDERPLAN, INC. - SHMO

Organization Marketing Name: Elderplan, Inc.Parent Organization: Elderplan, Inc.

Local CCP Organization Type: AVP Sales Admin., Informatics and Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Lois Faust 3/1/1985 Contract Effective Date: 1-718-759-4080 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-718-921-8824 Fax:

Enrollment: 14,793 [email protected] Email: 6323 Seventh Avenue Address:

6323 SEVENTH AVENUE Legal Entity Address: BrooklynCity:

BROOKLYN City: NYState: NYState: 11220Zip: 112204711 Zip: 3/9/2008Last Updated:

Contract Number: H9103 Legal Entity Name: KAISER FOUNDATION HP OF THE N W

Organization Marketing Name: Kaiser Permanente Parent Organization: Kaiser Foundation Health Plan, Inc.




Address: 500 NE Multnomah St.,Suite 100 Legal Entity Address: 500 NE Multnomah St

SUITE 500 City: Portland City: PORTLAND State: OR



Organization Marketing Name: SCAN Health Plan Parent Organization: SCAN Health Plan, Inc.

Organization Type: Local CCP Contact Title: Vice President, Marketing Plan Type: HMO/HMOPOS Name: Hans Eckardt



Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Airport Way Suite 100







CMS Region Responsible: San Francisco Fax: 1-714-226-6811 Enrollment: * Email: [email protected]

Address: 5757 Plaza Dr Legal Entity Address: c/o UnitedHealth Group/Ovations, 9900 Bren Rd East, CA124-0142

MAIL ROUTE MN008-\W240 City: Cyress City: Minnetonka State: CA



Contract Number: H9266 Legal Entity Name: PIEDMONT HEALTH SERVICES, INC.

Organization Marketing Name: Piedmont Health SeniorCare Parent Organization: PIEDMONT HEALTH SERVICES, INC.

National PACE Organization Type: Executive Director, Piedmont Health SeniorCare Contact Title: National PACE Plan Type: Name: Marianne C Ratcliffe 10/1/2008 Contract Effective Date: 1-336-532-0000 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-336-532-0001 Fax:

Enrollment: 23 [email protected] Email: 1214 Vaughn Road Address:

1214 Vaughn Road Legal Entity Address: BurlingtonCity:

Burlington City: NCState: NCState: 27217Zip: 27217 Zip: 9/9/2008Last Updated:

Contract Number: H9302 Legal Entity Name: PUGET SOUND HEALTH PARTNERS, INC.

Organization Marketing Name: Puget Sound Health Partners Parent Organization: Puget Sound Health Partners, Inc.

Local CCP Organization Type: Director of Marketing Contact Title: HMO/HMOPOS Plan Type: Name: Christine K Turner 1/1/2008 Contract Effective Date: 1-253-779-8830 Phone: For Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-253-779-8829 Fax:

Enrollment: 4,445 [email protected] Email: 400 Mercer St Address:

7502 Lakewood Dr. W, Legal Entity Address: Suite 410 Suite A SeattleCity: Lakewood City: WAState: WAState: 98109Zip: 98499 Zip: 5/19/2009Last Updated:

Contract Number: H9313 Legal Entity Name: MEDICAL MUTUAL OF OHIO

Organization Marketing Name: Advantage Plans from Medical Mutual of Ohio Parent Organization: MEDICAL MUTUAL OF OHIO

Organization Type: Local CCP Contact Title: Manager, Performance Group Call Center Plan Type: HMO/HMOPOS Name: Nancy Peebles



Address: 2060 East Ninth Street Legal Entity Address: 2060 East Ninth Street

City: Cleveland City: Cleveland State: OH


Contract Number: H9385 Legal Entity Name: SCAN HEALTH PLAN OF ARIZONA

Organization Marketing Name: SCAN Health Plan Arizona Parent Organization: SCAN Health Plan, Inc.

Organization Type: Local CCP Contact Title: President Plan Type: HMO/HMOPOS Name: Thomas Lescault



Address: 1313 East Osborn Road Legal Entity Address: 3800 Kilroy Airport Way Suite 100 Suite 150

City: Phoenix City: Long Beach State: AZ



Contract Number: H9452 Legal Entity Name: ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.








Contract Number: H9466 Legal Entity Name: HMO MISSOURI, INC.
















Contract Number: H9519 Legal Entity Name: INDEPENDENT HEALTH BENEFITS CORPORATION


Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Member Services



Address: 511 Farber Lakes Drive Legal Entity Address: 511 Farber Lakes Drive

City: Buffalo City: Buffalo State: NY




Legal Entity Name: MVP HEALTH PLAN, INC.Organization Marketing Name: MVP HEALTH CARE

Parent Organization: MVP HEALTH PLAN, INC.Organization Type: Local CCP Contact Title: Sales Manager Medicare

Plan Type: Local PPO Name: Catherine Mercury Contract Effective Date: 1/1/2009 Phone: 1-888-280-6205

Tax Status: Not-for-Profit/Non-Profit Extension: CMS Region Responsible: New York Fax:

Enrollment: 1,103 Email: [email protected] Address: 220 Alexander St

Legal Entity Address: 625 State Street City: Rochester

City: Schenectady State: NY State: NY Zip: 14607







Contract Number: H9670 Legal Entity Name: UPMC HEALTH BENEFITS, INC.


Organization Type: Local CCP Contact Title: Medicare Hotline Plan Type: Local PPO Name: UPMC Health Plan


CMS Region Responsible: Philadelphia Fax: Enrollment: * Email: [email protected]

Address: 112 Washington Place Legal Entity Address: 112 Washington Place



Contract Number: H9720 Legal Entity Name: AMERICA'S 1ST CHOICE HEALTH PLANS, INC.

Organization Marketing Name: AMERICA'S 1ST CHOICE HEALTH PLANS, INC. Parent Organization: Dr. Kiran C. Patel

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Robin Florez



Address: 5403 N. Church Ave. Legal Entity Address: 140 Stoneridge Drive Suite 480

City: Tampa City: Columbia State: FL



Contract Number: H9793 Legal Entity Name: HIGHMARK, INC.

Organization Marketing Name: Highmark Inc. Parent Organization: Highmark Inc.

PFFS Organization Type: Vice President, Operations Contact Title: PFFS Plan Type: Name: Sally Rich 1/1/2008 Contract Effective Date: 1-412-544-3186 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 20,574 [email protected] Email: 120 Fifth Avenue Address:

120 Fifth AvenueLegal Entity Address: Suite P5501 Suite P5501 PittsburghCity: Pittsburgh City: PAState: PAState: 15222Zip: 15222 Zip: 5/18/2007Last Updated:


Organization Marketing Name: Coventry Health Care Parent Organization: Coventry Health Care Inc.

Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Customer Service Org 1/1/2009 Contract Effective Date: 1-866-731-9574 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 2,612 [email protected] Email: 3721 TecPort DriveAddress:

6705 Rockledge Drive Legal Entity Address: Suite 900 Harrisburg City: Bethesda City: PAState: MDState: 17111Zip: 20817 Zip: 4/14/2009Last Updated:

Contract Number: H9859 Legal Entity Name: MVP HEALTH PLAN, INC,

Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP HEALTH PLAN, INC.

Organization Type: Local CCP Contact Title: Sales Manager Medicare Plan Type: HMO/HMOPOS Name: Catherine Mercury



Address: 220 Alexander St Legal Entity Address: 625 State Street

City: Rochester City: Schenectady State: NY


Contract Number: H9882 Legal Entity Name: VIRGINIA PREMIER HEALTH PLAN, INC.

Organization Marketing Name: Virginia Premier Gold Parent Organization: Virginia Premier Health Plan, Inc.


600 EAST BROAD STREET SUITE 400 RICHMOND VA 23220




City: State:

Zip:


Enrollment: 304


Director, Medicare Programs

1-804-819-5151 5451 1-804-819-5187 [email protected] 600 E Broad St

Richmond VA 23220 6/13/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Jill Sumner










Contract Number: H9931 Legal Entity Name: HEALTHPARTNERS INSURANCE COMPANY

Organization Marketing Name: HealthPartners Liberty Medicare Parent Organization: HealthPartners, Inc.

PFFS Organization Type: Contact Title: PFFS Plan Type: Name: Provider Services 1/1/2008 Contract Effective Date: 1-952-883-7699 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 98 [email protected] Email: 8170 33rd Avenue South Address:

8170 33rd Ave. S Legal Entity Address: PO Box 1309 Minneapolis City:

Bloomington City: MNState: MNState: 55440-1309 Zip: 55425 Zip: 4/24/2008Last Updated:

Contract Number: H9951 Legal Entity Name: FIRSTSOLUTIONS DBA FIRST PLAN OF MINNESOTA

Organization Marketing Name: FirstPlan Blue Parent Organization: Blue Cross and Blue Shield of Minnesota

Organization Type: Local CCP Contact Title: Marketing/Communications Manager Plan Type: HMO/HMOPOS Name: Gardner Lepp



Address: 525 S Lake Avenue Legal Entity Address: 525 S. Lake Suite 222 Suite 222

City: Duluth City: Duluth State: MN


Contract Number: R3175 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY


Organization Type: Regional CCP Contact Title: Plan Type: Regional PPO Name: Richard Irwin



Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA124-0142




Contract Number: R3444 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.


Regional CCP Organization Type: Marketing Manager Contact Title: Regional PPO Plan Type: Name: Misty Smith 1/1/2007 Contract Effective Date: 1-410-625-2200 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 9,036 [email protected] Email: 351 West Camden Street Address:




Regional CCP Organization Type: Contact Title: Regional PPO Plan Type: Richard IrwinName: 1/1/2006 Contract Effective Date: 1-888-867-5517 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:




Contract Number: R5342 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK






Contract Number: R5566 Legal Entity Name: BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE

Organization Marketing Name: MedicareBlue PPO Parent Organization: Blue Cross and Blue Shield of Minnesota

Organization Type: Regional CCP Contact Title: Plan Type: Regional PPO Name: Member Service



Address: MedicareBlue PPO Legal Entity Address: 3400 Yankee Drive, R336 1901 Market Street - Sp-2nd Flr

City: Philadelphia City: Eagan State: PA



Contract Number: R5595 Legal Entity Name: AETNA LIFE INSURANCE COMPANY


Organization Type: Regional CCP Contact Title: Plan Type: Regional PPO Name: Aetna Customer Service



Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Ave



Contract Number: R5674 Legal Entity Name: SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.


Regional CCP Organization Type: Director, Government Programs/Member Services Contact Title: Regional PPO Plan Type: Name: David Stuczynski 1/1/2006 Contract Effective Date: 1-702-838-2066 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-702-240-6281 Fax:

Enrollment: 3,525 [email protected] Email: 2716 N. Tenaya Way Address:

2720 N. Tenaya Way Legal Entity Address: Las Vegas City:

Las Vegas City: NVState: NVState: 89128Zip: 89128 Zip: 6/12/2008Last Updated:

Contract Number: R5826 Legal Entity Name: HUMANA INSURANCE COMPANY


Regional CCP Organization Type: Contact Title: Regional PPO Plan Type: Name: Customer Service 1/1/2006 Contract Effective Date: 1-800-457-4708 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:




Contract Number: R5863 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY

Organization Marketing Name: Health Net Parent Organization: Health Net, Inc.

Regional CCP Regional PPO 1/1/2006

1230 West Washington St. Suite 401 Tempe AZ 852812145

For Profit Seattle



City: State:

Zip:


Enrollment: 4,249


Provider and Provider Directory Information

1-800-977-7522

[email protected] P.O. Box 881

Shelton CT 06484 8/21/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: R5941 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC.


Organization Type: Regional CCP Contact Title: Plan Type: Regional PPO Name: Customer Service






Contract Number: R6801 Legal Entity Name: CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY


Regional CCP Organization Type: Marketing Manager Contact Title: Regional PPO Plan Type: Name: Misty Smith 1/1/2007 Contract Effective Date: 1-410-625-2200 Phone: For Profit Tax Status: 8701Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 14,820 [email protected] Email: 351 West Camden Street Address:






c/o UnitedHealth Group/Ovations, 9900 Bren Rd East Legal Entity Address: CA124-0142 MAIL ROUTE MN008-W240 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

Contract Number: R9896 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO


Regional CCP Regional PPO 1/1/2007

351 West Camden Street Suite 100 Baltimore MD 21201




City: State:

Zip:


Enrollment: 30,085


Marketing Manager

1-410-625-2200


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Misty Smith


Contract Number: R9943 Legal Entity Name: ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.


Regional CCP Organization Type: Contact Title: Regional PPO Plan Type: Name: Customer Service 1/1/2006 Contract Effective Date: 1-877-811-3107 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:


1 WellPoint Way Legal Entity Address: CAT201-C004 OxnardCity: Thousand Oaks City: CAState: CAState: 93031-9154 Zip: 90362 Zip: 4/25/2008Last Updated:


plan directory for medicare advantage, cost, pace, and ... · contract number: 90091 legal entity...

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