Plan Directory for Medicare Advantage, Cost, … · Plan Directory for Medicare Advantage, Cost,...

Plan Directoryfor

Medicare Advantage, Cost, PACE, and Demonstration

Organizations

Sorted by Contract Number

CPC/MDBG/DPDJuly 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: 35,908 [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: 11,550 [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

Employer/Union Only Direct Contract PFFS Organization Type: Contact Title: Employer/Union Only Direct Contract PFFS Plan Type: Name: Susana Garcia 1/1/2008 Contract Effective Date: 1-787-767-2020 Phone: Not-for-Profit/Non-Profit Tax Status: 1391Extension: New York CMS Region Responsible: 1-787-763-2726 Fax:

Enrollment: 2,029 [email protected] Email: 452 Ponce de Le≤n Ave. Address:

452 Ponce de Leon Ave Legal Entity Address: San JuanCity:

San Juan City: PRState: PRState: 00919Zip: 00917 Zip: 6/25/2008Last Updated:

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: 320 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

State: PR Zip: 00927 Zip: 00927 Last Updated: 2/8/2008

July 2009 Contract Directory Sorted by Contract Number Page 3 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: 19 [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: 175 [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: 66,991 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 Parent Organization: The Methodist Oaks

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:

Phone: Extension:

Fax: Email:

Address:

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Zip: Last Updated:

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: 2,448


Plan Directory Contact

1-888-888-9355 3091

[email protected] 8735 Henderson Road

Tampa FL 33634 5/19/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Mary Solomon

CARESOURCE MICHIGAN H0141


Organization Marketing Name: CareSource Parent Organization: CareSource

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: 84


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:

Phone: Extension:

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Address:

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Name: Michelle Chapman

HEALTHSPRING OF ALABAMA, INC. H0150


Healthspring of Alabama, Inc. Organization Marketing Name: Parent Organization: HealthSpring, Inc.


Two Chase Corporate Drive Ste 300 BIRMINGHAM AL 35244

For Profit Denver



City: State:

Zip:


Enrollment: 30,219


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:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

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: 33,023 [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: 28,271 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: 33 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: 1,899 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: 9,716 [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: Seattle 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



410 NORTH 44TH STREET PO BOX 52078 PHOENIX AZ 850722078

For Profit San Francisco



City: State:

Zip:


Enrollment: 94,778


HUMANA HEALTH PLAN, INC. H0307


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


201 West Main Street

Louisville KY 40202

For Profit Kansas City



City: State:

Zip:


Enrollment: 11,265


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:

City: State:

Zip: Last Updated:

Richard IrwinName:

1-800-457-4708

[email protected] 101 East Main Street

Louisville KY 40202 8/22/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

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: 8,576 [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: 1,287 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: 7,461 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: 3,017 [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: 15,503 [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: 385 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: 9,875 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: 59 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: 60,426 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: 629 [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: 1,766


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:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

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: 15 [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: 62 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: 625


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: 28,021 [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: 710,499 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: 104,054 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: 467 [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: 32,591


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

Contract Effective Date: 6/1/1986 Phone: 1-800-251-8191 Tax Status: Not-for-Profit/Non-Profit Extension: 426


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: 7,285


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: 21,938 [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: 1,321 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: 3,294 [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

State: CO Zip: 80014 Zip: 80247 Last Updated: 8/24/2006


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: 554 [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: Plan Directory Contact Contact Title: HMO/HMOPOS Plan Type: Name: Mary Solomon 5/1/2005 Contract Effective Date: 1-888-888-9355 Phone: For Profit Tax Status: 3091Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 3,823 [email protected] Email: 8735 Henderson Road Address:

116 WASHINGTON AVENUE Legal Entity Address: TampaCity:

NORTH HAVEN City: FLState: CTState: 33634Zip: 06437 Zip: 6/15/2009Last 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: 1,926


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

Local CCP Organization Type: Vice President Medicare Operations & Compliance Contact Title: HMO/HMOPOS Plan Type: Name: Connie Snyder 4/1/2006 Contract Effective Date: 1-562-310-6868 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-562-981-5818 Fax:

Enrollment: 1,394 [email protected] Email: 1680 East Hill Street Address:

1680 EAST HILL STREET Legal Entity Address: Building 3 Signal HillCity: SIGNAL HILL City: CAState: CAState: 90755Zip: 90755 Zip: 6/2/2009Last Updated:

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: 188,857 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




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: Seattle 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 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: 6/15/2009

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: 763 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: 830 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: 3,222 [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: 21,441


CARE PLUS HEALTH PLAN H1019


Organization Marketing Name: CarePlus Health Plans, Inc. Parent Organization: Humana Inc.


11430 NW 20th Street Suite 300 Doral FL 33172




City: State:

Zip:


Enrollment: 63,118


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: 23,397 [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.




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: 14,185


HUMANA MEDICAL PLAN, INC H1036


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


3501 SW 160th Avenue

Miramar FL 33027




City: State:

Zip:


Enrollment: 266,076


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: 155 [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: 20,798 [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



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

City: Sunrise City: Sunrise State: FL


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: 22,843 [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: 284 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.





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: 23,222 [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: 11 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: 36,488


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: 7,775 [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: 279


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: 5,571 [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: H1310 Legal Entity Name: COMPREHENSIVE SENIOR CARE CORPORATION

Organization Marketing Name: CentraCare Parent Organization: Comprehensive Senior Care Corporation

National PACE Organization Type: Executive Director Contact Title: National PACE Plan Type: Name: Rod Auton 4/1/2009 Contract Effective Date: 1-269-441-2681 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-269-441-0974 Fax:

Enrollment: 20 [email protected] Email: 200 West Michigan Address:

200 W. Michigan Avenue Legal Entity Address: Battle Creek City:

Battle Creek City: MIState: MIState: 49017Zip: 49017 Zip: 7/17/2008Last 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: 22


Member Services Representative

1-866-422-5009

[email protected] 4888 Loop Central Drive Suite 900 Houston TX 77081 6/17/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Member Services


Contract Number: H1326 Legal Entity Name: PRIORITY HEALTH

Organization Marketing Name: PriorityMedicarePFFS Parent Organization: Spectrum Health System



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

Address: 1231 East Beltline Ave NE Legal Entity Address: 1231 East Beltline NE

City: Grand Rapids City: Grand Rapids State: MI

State: MI Zip: 49525 Zip: 49525 Last Updated: 1/31/2008

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


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


CMS Region Responsible: Seattle Fax: 1-208-387-6811 Enrollment: 20,931 Email: [email protected]

Address: 3000 E. Pine Ave. Legal Entity Address: 3000 E. PINE AVE.

City: Meridian City: MERIDIAN State: ID

State: ID Zip: 83642 Zip: 83642 Last Updated: 8/27/2007

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


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


CMS Region Responsible: Dallas Fax: Enrollment: 118 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: 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: San Francisco 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.


9701 W Higgins Road SUITE 360 Rosemont IL 60018

For Profit Denver



City: State:

Zip:


Enrollment: 10,852


Vice President, Customer Service

1-832-553-3300 3379

[email protected] 2900 North Loop West Suite1300 Houston TX 77092 12/3/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendy Wetzel


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




125 SOUTH WACKER DRIVE SUITE 2600 Legal Entity Address: TampaCity:

CHICAGO City: FLState: ILState: 33634Zip: 606064402 Zip: 1/12/2009Last Updated:



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: 3,371 [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: Contact Title: Local PPO Plan Type: Name: Aetna Customer Service 9/1/2005 Contract Effective Date: 1-800-445-1796 Phone: For Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 717 [email protected] Email: 151 Farmington Avenue Address:

151 Farmington Avenue Legal Entity Address: Hartford City:

Hartford City: CTState: CTState: 06156Zip: 06156 Zip: 8/23/2006Last Updated:



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: 6,365 [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: HUMANA BENEFIT PLAN OF ILLINOIS, INC

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




Address: 101 East Main Street Legal Entity Address: 201 West Main Street

City: Louisville City: Louisville State: KY

State: KY Zip: 40202 Zip: 40202 Last Updated: 7/3/2008






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.

1876 Cost 1876 Cost 1/1/1993

1776 N. Meridian, Suite 300

Indianapolis IN 46202

For Profit Chicago



City: State:

Zip:


Enrollment: 5,072


Customer Solutions Center Manager

1-317-963-9700

1-317-963-9800 [email protected] 1776 N. Meridian Street Suite 300 Indianapolis IN 46202 3/18/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Trina Gibson


Contract Number: H1558 Legal Entity Name: WELBORN HEALTH PLAN

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

Organization Type: 1876 Cost Contact Title: Product Manager Plan Type: 1876 Cost Name: David Marx


CMS Region Responsible: Chicago Fax: 1-812-773-0572 Enrollment: 1,856 Email: [email protected]

Address: 101 SE Third St Legal Entity Address: 101 S.E. Third Street

City: Evansville City: EVANSVILLE State: IN

State: IN Zip: 47708 Zip: 47708 Last Updated: 4/30/2008









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.

Organization Type: PFFS Contact Title: VP, Sr. Products Operations Plan Type: PFFS Name: Sally Rich



Address: 120 Fifth Avenue Legal Entity Address: 120 Fifth Avenue Suite P5501

Suite P5501 City: Pittsburgh City: Pittsburgh State: PA


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: 8,108 [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.





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








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: 167 [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:














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

MN008-T500 City: Cyress City: MINNETONKA State: CA

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


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

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

Local CCP Organization Type: Director of Operations Contact Title: HMO/HMOPOS Plan Type: Name: Khaibah Stuart 1/1/2008 Contract Effective Date: 1-646-233-5723 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-646-233-5745 Fax:

Enrollment: 578 [email protected] Email: 155 E 56 ST Address:

1339 York Avenue Legal Entity Address: 2ND FLOOR New York City:

New York City: NYState: NYState: 10022Zip: 10021 Zip: 3/24/2009Last Updated:



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



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

Organization Marketing Name: Essence Healthcare Parent Organization: Essence LLP

Organization Type: Local CCP Contact Title: DIrector, Claims and Customer Service Plan Type: HMO/HMOPOS Name: Dawn Walter



Address: 13900 Riverport Drive Legal Entity Address: 13900 Riverport Drive

` City: Maryland Heights City: Maryland Heights State: MO

State: MO Zip: 63043 Zip: 63043 Last Updated: 6/5/2009

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: 472 [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.



8735 Henderson Rd Ren 1 Tampa FL 33634

For Profit Atlanta



City: State:

Zip:


Enrollment: 3,943



1-888-888-9355 3091


Tampa FL 33634 1/12/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Mary Solomon


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

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

Organization Type: National PACE Contact Title: Director of Finance Plan Type: National PACE Name: Christophe K Meguess



Address: 4201 N RAMPART ST Legal Entity Address: 4201 N. Rampart Street

City: NEW ORLEANS City: ORLEANS State: LA

State: LA Zip: 70117 Zip: 70117 Last Updated: 5/23/2007

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:





CMS Region Responsible: San Francisco Fax: 1-714-226-6811 Enrollment: 538 Email: [email protected]

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

Mail Route MN-008 W140 City: Cyress City: Minnetonka State: CA


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

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 7/1/1997 Contract Effective Date: 1-800-631-8443 Phone: For Profit Tax Status: 2Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 42,298 [email protected] Email: Three Lakeway Center Address:

Three Lakeway Center Legal Entity Address: 3838 N Causeway Blvd, Suite 2200 3838 N Causeway Blvd., Suite 2200 Metairie City: Metairie City: LAState: LAState: 70002Zip: 70002 Zip: 9/15/2006Last Updated:

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















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.



383 F.D. Roosevelt AvenueLegal Entity Address: 3rd Floor LouisvilleCity: San Juan City: KYState: PRState: 40202Zip: 00918 Zip: 2/11/2009Last Updated:

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: Director of Corporate Services Plan Type: HMO/HMOPOS Name: Becky Horn



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

City: Milwaukee City: Milwaukee State: WI







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


3155 Avenue C

Billings MT 59102




City: State:

Zip:


Enrollment: 23


Director

1-406-247-6320

1-406-247-6318 [email protected] 3155 Avenue C

Billings MT 59012 5/7/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Anne GonzalezName:


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

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

National PACE Organization Type: Director, LIFE Geisinger Contact Title: National PACE Plan Type: Name: Amy L Minnich 6/1/2008 Contract Effective Date: 1-570-373-2100 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: 1-570-373-2101 Fax:

Enrollment: 109 [email protected] Email: 100 North Academy Avenue Address:

100 North Academy Avenue Legal Entity Address: MC 6065 MC 60-65 DanvilleCity: Danville City: PAState: PAState: 17822-6065 Zip: 178226065 Zip: 5/14/2008Last Updated:

Contract Number: H2108 Legal Entity Name: BRAVO HEALTH MID- ATLANTIC INC.




CMS Region Responsible: Philadelphia Fax: 1-410-864-4459 Enrollment: 12,182 Email: [email protected]


City: Baltimore City: BALTIMORE State: MD


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: 128 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)




1302 Concourse Drive, Suite 402 Legal Entity Address: Hartford City:

LinthicumCity: CTState: MDState: 06156Zip: 21090 Zip: 8/23/2006Last Updated:

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: 37,325 [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: 69 [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


1800 Millrace Drive

Eugene OR 97403

For Profit Seattle



City: State:

Zip:


Enrollment: 2,946


Medicare Director

1-541-485-2155

1-541-984-5685 [email protected] 1800 Millrace Drive

Eugene OR 97440 1/18/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Shannon Conley






c/o UnitedHealth Group/Ovations, 9900 Bren Rd East, Legal Entity Address: CA124-0142 Mail Rout MN008-W840 CyressCity: Minnetonka City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

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: 297 [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.

Organization Type: National PACE Contact Title: Director of Operations Plan Type: National PACE Name: Jagdeep Trivedi


CMS Region Responsible: Boston Fax: 1-617-474-0757 Enrollment: 146 Email: [email protected]

Address: 1140 Dorchester Ave. Legal Entity Address: 500 Columbia Road

Mail Stop 1140-08 City: Dorchester City: DORCHESTER State: MA



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

National PACE Organization Type: Financial Analyst llContact Title: National PACE Plan Type: Name: Estenieau Jean 11/1/2002 Contract Effective Date: 1-781-306-8671 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: 1-781-306-8660 Fax:

Enrollment: 203 [email protected] Email: 270 Green Street Address:

270 GREEN STREET Legal Entity Address: Cambridge City:

CAMBRIDGE City: MAState: MAState: 02139Zip: 02139 Zip: 5/24/2007Last Updated:

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



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: 283 [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


58 Charles Street, 2nd Floor

CAMBRIDGE MA 02141

For Profit Boston



City: State:

Zip:


Enrollment: 4,901


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: 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.


705 Mt Auburn Street

Watertown MA 02471

Not-for-Profit/Non-Profit Boston



City: State:

Zip:


Enrollment: 4,935


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: H2230 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.

Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Member Services 9/1/2005 Contract Effective Date: 1-800-200-4255 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:

Enrollment: 1,543 [email protected] Email: One Enterprise Drive Address:

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

BOSTON City: MAState: MAState: 02171Zip: 022153326 Zip: 8/23/2006Last Updated:

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: 3,054 [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: 74,873 [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: HMO/HMOPOS Name: Member Services Contract Effective Date: 1/1/1996 Phone: 1-800-200-4255

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

Enrollment: 31,311 Email: [email protected] Address: One Enterprise Drive

Legal Entity Address: 401 PARK DRIVE City: N. Quincy

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

Zip: 02215 Last Updated: 2/1/2008


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

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

Local CCP Organization Type: System Information Manager Contact Title: HMO/HMOPOS Plan Type: Emmanuel Morales Name: 1/1/2008 Contract Effective Date: 1-787-200-1101 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 131 [email protected] Email: Suite 232, 85 De Diego Avenue Address:

Suite 232, 85 De Diego Avenue Legal Entity Address: San JuanCity:

San Juan City: PRState: PRState: 00927Zip: 00967 Zip: 3/28/2008Last Updated:

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: 30,804 [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

Organization Type: National PACE Contact Title: Director Plan Type: National PACE Name: Linda McCarver



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

City: Detroit City: DETROIT State: MI


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

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



Address: 27000 West Eleven Mile Road Legal Entity Address: 600 Lafayette East H 404

City: Southfield City: Detroit State: MI



Contract Number: H2320 Legal Entity Name: PRIORITY HEALTH

Organization Marketing Name: PriorityMedicare Parent Organization: Spectrum Health System

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 7/1/2005 Contract Effective Date: 1-888-389-6648 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 16,310 [email protected] Email: 1231 East Beltline Ave NE Address:

1231 EAST BELTLINE AVE N.E. Legal Entity Address: Grand Rapids City:

GRAND RAPIDS City: MIState: MIState: 49525Zip: 49525 Zip: 8/21/2006Last 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: 3,301 [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


Contract Number: H2354 Legal Entity Name: HEALTHPLUS OF MICHIGAN

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


2050 S. Linden Road P.O. BOX 1700 FLINT MI 485011700




City: State:

Zip:


Enrollment: 11,232


Director of Medicare Services

1-800-332-9161

1-810-733-1958 [email protected] 2050 S. Linden Road P.O. Box 1700 Flint MI 48501-1700 3/17/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Jacob CollinsName:


APPALACHIAN AENCY FOR SENIOR CITIZENS, INC. H2386


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

Not-for-Profit/Non-Profit Philadelphia



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:

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Name: Patrick DeMesa

UNITEDHEALTHCARE INSURANCE COMPANY H2406


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


9900 BREN ROAD EAST MN008-W130 MINNETONKA MN 55343




City: State:

Zip:


Enrollment: 1,959


1-888-867-5518


Contact Title:

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Zip: Last Updated:

Richard IrwinName:

UCARE MINNESOTA H2407


Organization Marketing Name: UCare Parent Organization: UCare Minnesota


500 Stinson Blvd NE

MINNEAPOLIS MN 55413




City: State:

Zip:


Enrollment: 683


State Programs Member Services Supervisor

1-612-676-3456

[email protected] PO Box 52

Minneapolis MN 55440 5/25/2007

Contact Title:

Phone: Extension:

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Address:

City: State:

Zip: Last Updated:

Name: Jaimie Parker

MEDICA INSURANCE COMPANY H2409


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: 265


1-800-234-8755

[email protected] 401 Carlson Parkway

Minnetonka MN 55305 9/6/2006

Contact Title:

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Contract Number: H2410 Legal Entity Name: MEDICA HEALTH PLANS

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




Address: 401 Carlson Parkway Legal Entity Address: 401 CARLSON PARKWAY

City: Minnetonka City: MINNETONKA State: MN



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: 2,062 [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


1219 SE 2ND AVENUE

GRAND RAPIDS MN 55744




City: State:

Zip:


Enrollment: 475


Program Director

1-218-327-5517

1-218-327-5545 [email protected] 1219 SE 2nd Ave.

Grand Rapids MN 55744 5/15/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Brett Skyles Name:


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

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

Organization Type: Local CCP Contact Title: Manager Marketing and Communication Plan Type: HMO/HMOPOS Name: Ellen Lewis



Address: 110 West Fremont Street Legal Entity Address: 110 West Fremont Street

City: Owatonna City: OWATONNA State: MN


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

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 AVE, SUITE 222 Suite 222

City: Duluth City: DULUTH State: MN


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



MEDICA INSURANCE COMPANY H2450


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

1876 Cost 1876 Cost 1/1/1990

401 Carlson Parkway P.O. BOX 9310 MINNEAPOLIS MN 554409310




City: State:

Zip:


Enrollment: 70,913


1-800-234-8755



Contact Title:

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500 Stinson Blvd NE





City: State:

Zip:


Enrollment: 8,258


State Programs Member Services Supervisor

1-612-676-3456



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Jaimie Parker

METROPOLITAN HEALTH PLAN H2457


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


400 South Fourth Street Suite 201 Minneapolis MN 55415




City: State:

Zip:


Enrollment: 743


Government Programs Manager

1-612-596-9953

[email protected] 400 South 4th Street Suite 201 Minneapolis MN 55415 10/14/2008

Contact Title:

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Address:

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Zip: Last Updated:

Name: Susan Sommers

MEDICA HEALTH PLANS H2458




401 Carlson Parkway

MINNETONKA MN 55305




City: State:

Zip:


Enrollment: 8,495


1-800-234-8755



Contact Title:

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Address:

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500 Stinson Boulevard NE





City: State:

Zip:


Enrollment: 60,183


Medicare Customer Services Supervisor

1-612-676-3471



Contact Title:

Phone: Extension:

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Address:

City: State:

Zip: Last Updated:

Name: Vatisha Hammick

BLUE CROSS BLUE SHIELD OF MINNESOTA H2461


Blue Cross Blue Shield of Minnesota Organization Marketing Name: Blue Cross and Blue Shield of Minnesota Parent Organization: 1876 Cost 1876 Cost 1/1/1999

3400 Yankee Drive

Eagan MN 55122




City: State:

Zip:


Enrollment: 761


1-888-740-6013

[email protected] 3400 Yankee Drive

Eagan MN 55121-1627 9/11/2006

Contact Title:

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Zip: Last Updated:


GROUP HEALTH INC, H2462


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

1876 Cost 1876 Cost 1/1/1999

8170 33rd Avenue South PO Box 1309 MINNEAPOLIS MN 554401309




City: State:

Zip:


Enrollment: 36,294


1-952-883-7699

[email protected] 8170 33rd Avenue South PO Box 1309 Minneapolis MN 55440-1309 4/24/2008

Contact Title:

Phone: Extension:

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Address:

City: State:

Zip: Last Updated:

Name: Provider Services

MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION H2481


Organization Marketing Name: CareSource Mid Rogue Community Health Plan Parent Organization: Local CCP Local PPO 1/1/2008

740 SE 7th Street

Grants Pass OR 97526

For Profit Seattle



City: State:

Zip:


Enrollment: 66


Director of Marketing

1-541-471-4106

1-541-471-1524 [email protected] 740 SE 7th Street

Grants Pass OR 97526 9/20/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Freddy Sennhauser


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

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


Enrollment: 363 [email protected]: 101 East Main Street Address:



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



Enrollment: 620 [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



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

City: Chambersburg City: Chambersburg State: PA







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




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

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

National PACE Organization Type: Marketing Director Contact Title: National PACE Plan Type: Name: Rebecca Boerner 11/1/2001 Contract Effective Date: 1-314-771-5800 Phone: Not-for-Profit/Non-Profit Tax Status: 159Extension: Kansas CityCMS Region Responsible: 1-314-771-7830 Fax:

Enrollment: 153 [email protected] Email: 3900 S. Grand Address:

3900 SOUTH GRAND BOULEVARD Legal Entity Address: St. LouisCity:

ST. LOUIS City: MOState: MOState: 63118Zip: 63118 Zip: 6/14/2007Last Updated:







City: Maryland Heights City: Maryland Heights State: MO


Contract Number: H2611 Legal Entity Name: MERCY HEALTH PLANS

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

Organization Type: Local CCP Contact Title: Director Customer Contact Centers Plan Type: Local PPO Name: Ed Abrams


CMS Region Responsible: Kansas City Fax: 1-314-214-3268 Enrollment: 3,177 Email: [email protected]

Address: 14528 S. Outer 40, Ste. 300 Legal Entity Address: 14528 S.OUTER 40, SUITE 300

City: Chesterfield City: CHESTERFIELD State: MO


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 Medicare Advantage Parent Organization: L.A. Care Health Plan

Organization Type: Local CCP Contact Title: Director Medicare and Product Operations Plan Type: HMO/HMOPOS Name: Scott A Crawford



Address: 555 West 5th Street Legal Entity Address: 555 West 5th Street 29th Floor

29th Floor City: Los Angeles City: Los Angeles State: CA


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






Address: 101 East Main Street Legal Entity Address: 201 West Main Street

City: Louisville City: Louisville State: KY


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





Address: 5757 Plaza Dr Legal Entity Address: 13655 RIVERPORT DRIVE CA124-0142

City: Cyress City: MARYLAND HEIGHTS State: CA



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

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

Local CCP Organization Type: Medicare Marketing Department Contact Title: HMO/HMOPOS Plan Type: Name: GHP Medicare Marketing D 11/1/1995 Contract Effective Date: 1-800-276-2056 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 28,102 [email protected] Email: 550 Maryville Centre Drive Address:

550 Maryville Centre Drive Legal Entity Address: Suite 300 Suite 300 St. LouisCity: St. Louis City: MOState: MOState: 63141-5818 Zip: 631415818 Zip: 8/15/2007Last Updated:

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: 16,169 [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


101 E State St.

Kennett Square PA 19348

For Profit Philadelphia



City: State:

Zip:


Enrollment: 58


Finance Director

1-610-925-4077

1-610-925-4000 [email protected] 101 East State Street

Kennett Square PA 19348 5/1/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Karen M Wells


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

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

Organization Type: Local CCP Contact Title: Director of Government Programs Plan Type: Local PPO Name: Bonnie Franklin



Address: 1203 Highway 2 West, Suite 45 Legal Entity Address: 130 NEILL AVE

City: Kalispell City: HELENA State: MT

State: MT Zip: 59901 Zip: 59601 Last Updated: 3/26/2009

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: 15,385 [email protected] Email: 900 Cottage Grove Rd Address:

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










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

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

PFFS PFFS 1/1/2008

840 First Street NE Attn: Jordana Bradley Washington DC 20065




City: State:

Zip:


Enrollment: 62


Director, Pharmacy Management

1-410-528-7897

[email protected] 1501 S. Clinton St 8th Floor

Baltimore MD 21224 5/15/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Winston Wong


Contract Number: H2802 Legal Entity Name: UNITEDHEALTHCARE OF THE MIDLANDS, INC.




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

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






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: 124 [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:





For Profit Dallas



City: State:

Zip:


Enrollment: 20



1-866-422-5009


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last 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 Contact Title: Plan Type: HMO/HMOPOS Name: Member Service


CMS Region Responsible: Dallas Fax: Enrollment: 2,637 Email: [email protected]

Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington St., Suite 300

City: Oakland City: Oakland State: CA


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.

Local CCP Organization Type: Director, Government Programs/Member Services Contact Title: Local PPO Plan Type: Name: David Stuczynski 8/1/2005 Contract Effective Date: 1-702-838-2066 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-702-869-2484 Fax:

Enrollment: 538 [email protected] Email: 2720 N. Tenaya Way Address:

2724 N. Tenaya Way Legal Entity Address: Las Vegas City:

Las Vegas City: NVState: NVState: 89128Zip: 89128 Zip: 6/9/2009Last Updated:

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


CMS Region Responsible: Seattle Fax: 1-775-982-3741 Enrollment: 268 Email: [email protected]

Address: 830 Harvard Way Legal Entity Address: 830 HARVARD WAY

City: Reno City: RENO State: NV

State: NV Zip: 89502 Zip: 89502 Last Updated: 9/20/2007





For Profit Dallas



City: State:

Zip:


Enrollment: 31



1-866-422-5009


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



PRIMEWEST HEALTH SYSTEM H2926


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


2209 Jefferson Street Suite 101 Alexandria MN 56308




City: State:

Zip:


Enrollment: 190


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. Parent Organization: UnitedHealth Group, Inc.


2720 NORTH TENAYA WAY P.O. BOX 15645 LAS VEGAS NV 891145645




City: State:

Zip:


Enrollment: 1,033


Director, Government Programs/Member Services

1-702-838-2066

1-702-869-2484 [email protected] 2720 N. Tenaya Way

Las Vegas NV 89128 6/9/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: David Stuczynski

LIFECIRCLES H2936


Organization Marketing Name: LIFECIRCLES Parent Organization: LifeCircles


560 Seminole Road

Muskegon MI 49444




City: State:

Zip:


Enrollment: 18


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: Parent Organization: Sentara Health Care (SHC)


665 NEWTOWN ROAD SUITE 121 VIRGINIA BEACH VA 23462




City: State:

Zip:


Enrollment: 119


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


Contract Number: H2947 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE COMPANY

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

Organization Type: Local CCP Contact Title: Director Regulatory Compliance Plan Type: Local PPO Name: Barbara Sellman


CMS Region Responsible: Denver Fax: Enrollment: 271 Email: [email protected]

Address: 11 Stanwix Street Legal Entity Address: 6705 Rockledge Drive

Suite 900 City: Pittsburgh City: Bethesda State: PA









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.


2720 N. TENAYA WAY

LAS VEGAS NV 89128




City: State:

Zip:


Enrollment: 55,318



1-702-838-2066


Las Vegas NV 89128 6/9/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H2997 Legal Entity Name: ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC.








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: 919 [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:





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

Organization Type: Local CCP Contact Title: Medicare Product Manager Plan Type: HMO/HMOPOS Name: David Marx



Address: 101 S.E. Third Street Legal Entity Address: c/o Neighborhood Health Providers

521 Fifth Ave, Third Floor City: Evansville City: New York State: IN



Contract Number: H3057 Legal Entity Name: TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION,


PFFS Organization Type: Tufts MP Marketing Communications Manager Contact Title: PFFS Plan Type: Name: Dana Cutter 1/1/2008 Contract Effective Date: 1-617-972-9400 Phone: Not-for-Profit/Non-Profit Tax Status: 2759Extension: Boston CMS Region Responsible: Fax:

Enrollment: 1,568 [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: 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.





Address: 5757 Plaza Dr Legal Entity Address: 48 Monroe Turnpike CA124-0142

City: Cyress City: Trumbull State: CA


Contract Number: H3113 Legal Entity Name: OXFORD HEALTH PLANS (NJ), INC.





Address: 5757 Plaza Dr Legal Entity Address: 44 SOUTH BROADWAY CA124-0142

City: Cyress City: WHITE PLAINS State: CA



AIDS HEALTHCARE FOUNDATION MCO OF FLORIDA, INC. H3132


Positive Healthcare Partners Organization Marketing Name: Parent Organization: AIDS Healthcare Foundation


Health Plan Adminstrator

1-800-263-0067

1-323-436-5034 [email protected] 1001 N. Martel Ave.

LOS ANGELES CA 90046 6/1/2009

110 SE 6th St., Ste. 1960

Fort Lauderdale FL 33301




Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Michael O'Malley Name:

164


AETNA HEALTH, INC. H3152



Local CCP HMO/HMOPOS 9/1/1993 1-800-445-1796

[email protected] 151 Farmington Avenue

Hartford CT 06156 12/11/2007

55 LANE ROAD

FAIRFIELD NJ 070041098

For Profit Boston



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Name: Aetna Customer Service

36,702


HORIZON HEALTHCARE OF NEW JERSEY, INC. H3154


Horizon Blue Cross Blue Shield of New Jersey, Inc. Organization Marketing Name: Horizon Blue Cross Blue Shield of New Jersey, Inc. Parent Organization: Local CCP HMO/HMOPOS 1/1/1996

Director, Consumer & Senior Markets

1-800-224-1234

[email protected] Three Penn Plaza East , PP-09F

Newark NJ 07105 9/29/2008

3 PENN PLAZA EAST

NEWARK NJ 07105

For Profit New York



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Name: John Selby

54,800


AMERIHEALTH HMO_INC H3156


Organization Marketing Name: AmeriHealth 65 Independence Blue Cross Parent Organization: Local CCP HMO/HMOPOS 10/1/1995 1-800-331-0017

[email protected] 1901 Market Street

Phila. PA 19103 9/6/2007

1901 MARKET STRRET 45 TH FLOOR PHILADELPHIA PA 19103




Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

City: State:

Zip:


Enrollment:

Name: Plan Inquiries

2,096



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



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: Manager Provider Care Unit Contact Title: HMO/HMOPOS Plan Type: Name: Lisa Gutierrez 4/1/1986 Contract Effective Date: 1-505-923-5757 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-188-892-3575 Fax:


2501 BUENA VISTA SE Legal Entity Address: P.O. BOX 27489 Albuquerque City: ALBUQUERQUE City: NMState: NMState: 87125-4789 Zip: 87106 Zip: 6/15/2009Last Updated:

Contract Number: H3206 Legal Entity Name: PRESBYTERIAN INSURANCE COMPANY, INC.

Organization Marketing Name: Presbyterian MediCare PPO Parent Organization: Presbyterian Healthcare Services


P.O. BOX 27489 2501 BUENA VISTA, S.E. ALBUQUERQUE NM 871257489

For Profit Dallas



City: State:

Zip:


Enrollment: 4,190


Manager Provider Care Unit

1-800-923-5757

[email protected] P.O. Box 27489

Albuquerque NM 87125-4789 6/15/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Lisa Gutierrez


Contract Number: H3207 Legal Entity Name: LOVELACE INSURANCE COMPANY

Organization Marketing Name: Lovelace Insurance Company Parent Organization: Ardent Health Services.

Local CCP Organization Type: Medicare Compliance Officer Contact Title: Local PPO Plan Type: Name: Karen L Redman 8/1/2005 Contract Effective Date: 1-505-727-5658 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-505-727-5510 Fax:

Enrollment: 484 [email protected] Email: 4101 Indian School R. NE Address:

4101 INDIAN SCHOOL ROAD, N.E. Legal Entity Address: Suite 110S Albuquerque City:

ALBUQUERQUE City: NMState: NMState: 87111Zip: 87110 Zip: 2/24/2009Last Updated:

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


CMS Region Responsible: New York Fax: Enrollment: 1,211 Email: [email protected]

Address: AMERIGROUP Corporation Legal Entity Address: 399 Thornall Street 4200 West Cypress Street, Suite 900

Ninth Floor City: Tampa City: Edison State: FL


Contract Number: H3251 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: 27,145 [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.


220 Alexander Ave.

Rochester NY 14607




City: State:

Zip:


Enrollment: 70,912


Sales Manager, Medicare

1-888-280-6205

[email protected] 220 Alexander St

Rochester NY 14607 5/18/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Catherine Mercury



Legal Entity Name: OXFORD HEALTH PLANS (NY), INC.Organization Marketing Name: SecureHorizons by UnitedHealthcare

Parent Organization: UnitedHealth Group, Inc.Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Richard IrwinName: 10/1/1991 Contract Effective Date: 1-888-867-5517 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:


48 Monroe Turnpike Legal Entity Address: CA124-0142 CyressCity:

Trumbull City: CAState: CTState: 90630Zip: 06611 Zip: 4/14/2009Last Updated:






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

Organization Type: National PACE Contact Title: Plan Type: National PACE Name: Ginny Turley



Address: 100 Malta Lane Legal Entity Address: 100 MALTA LANE

City: North Syracuse City: NORTH SYRACUSE State: NY



Contract Number: H3322 Legal Entity Name: SENIOR CARE CONNECTION, INC.

Organization Marketing Name: Senior Care Connection, Inc. Parent Organization: Senior Care Connection, Inc.

National PACE Organization Type: VP/DIrector Contact Title: National PACE Plan Type: Name: Bernadette Hallam 11/1/2002 Contract Effective Date: 1-518-831-6349 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-518-382-3398 Fax:

Enrollment: 121 [email protected] Email: 504 State Street Address:

504 STATE STREET Legal Entity Address: Schenectady City:

SCHENECTADY City: NYState: NYState: 12303Zip: 12305 Zip: 8/21/2006Last Updated:

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


CMS Region Responsible: New York Fax: 1-212-294-8210 Enrollment: 13,897 Email: [email protected]

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.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Adrian Gardner



Address: 95-25 Queens Boulevard Legal Entity Address: 95-25 QUEENS BOULEVARD

City: Rego Park City: REGO PARK State: NY


Contract Number: H3329 Legal Entity Name: COMPREHENSIVE CARE MANAGEMENT CORP.

Organization Marketing Name: Comprehensive Care Management Corp. Parent Organization: Bethco Corporation

Organization Type: National PACE Contact Title: Plan Type: National PACE Name: Felice Liburd



Address: 2275 Olinville Avenue Legal Entity Address: 612 ALLERTON AVENUE

City: Bronx City: BRONX State: NY



Contract Number: H3330 Legal Entity Name: HIP OF GREATER NEW YORK

Organization Marketing Name: HIP Medicare HMO Parent Organization: EmblemHealth Inc.

Organization Type: Local CCP Contact Title: Manager, Outbound Customer Service Plan Type: HMO/HMOPOS Name: Willie Horne



Address: 55 Water Street Legal Entity Address: 55 Water Street

City: New York City: NEW YORK State: NY


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



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






Contract Number: H3335 Legal Entity Name: EXCELLUS HEALTH PLAN, INC.

Organization Marketing Name: Excellus Health Plan, Inc Parent Organization: Lifetime Healthcare, Inc.


165 Court St.

Rochester NY 14647




City: State:

Zip:


Enrollment: 24,337


Customer Service Department

1-800-659-1986

[email protected] 205 Park Club Lane

Buffalo NY 14221 2/12/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: * Customer Service


Contract Number: H3336 Legal Entity Name: NEIGHBORHOOD HEALTH PROVIDERS LLC

Organization Marketing Name: Neighborhood Health Providers Parent Organization: Brookdale University and Hospital

Local CCP Organization Type: Vice President Contact Title: HMO/HMOPOS Plan Type: Name: Audrey Brahamsha 1/1/2005 Contract Effective Date: 1-866-345-0013 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: 1-212-808-4772 Fax:

Enrollment: 3,103 [email protected] Email: 521 5th Avenue Address:

521 FIFTH AVENUE, THIRD FLOOR Legal Entity Address: Third Floor New York City:

NEW YORK City: NYState: NYState: 10175Zip: 10175 Zip: 12/11/2007Last Updated:

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: 2,852 [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: PO BOX 1010

City:City: BAYONNE State:

State: NJ Zip:Zip: 07002 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



INDEPENDENT HEALTH BENEFITS CORPORATION H3344


Organization Marketing Name: Independent Health Parent Organization: Independent Health Association, Inc.


511 FARBER LAKES DRIVE

BUFFALO NY 14221

For Profit New York



City: State:

Zip:


Enrollment: 3,265


1-800-665-1502

[email protected] 511 Farber Lakes Drive

Buffalo NY 14221 1/8/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


MVP HEALTH PLAN, INC. H3346




220 Alexander St.

ROCHESTER NY 14607




City: State:

Zip:


Enrollment: 1,375


Sales Manager Medicare

1-888-280-6205


Rochester NY 14607 5/18/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


ELDERPLAN, INC. H3347


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


6323 SEVENTH AVENUE

BROOKLYN NY 112204711




City: State:

Zip:


Enrollment: 994


AVP Sales Admin., Informatics and Customer Service

1-718-759-4080

1-718-921-8824 [email protected] 6323 Seventh Avenue

Brooklyn NY 11220 2/14/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Lois Faust

EXCELLUS HEALTH PLAN, INC. H3351


Organization Marketing Name: Excellus Health Plan, Inc Parent Organization: Lifetime Healthcare, Inc.


205 PARK CLUB LANE

Buffalo NY 14221




City: State:

Zip:


Enrollment: 48,758


Customer Service Department

1-800-659-1986

[email protected] 205 Park Club Lane

Buffalo NY 14221 5/20/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: * Customer Service



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 Contract Effective Date: 1/1/1993 Phone: 1-800-659-1986

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

Enrollment: 2,952 Email: [email protected] Address: 205 Park Club Lane

Legal Entity Address: 165 COURT STREET City: Buffalo

City: ROCHESTER State: NY State: NY Zip: 14221

Zip: 14647 Last Updated: 11/20/2008 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: 83,483 [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.





Address: 511 Farber Lakes Drive Legal Entity Address: 511 FARBER LAKES DRIVE

City: Buffalo City: BUFFALO State: NY



Contract Number: H3366 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

City: New York City: New York State: NY


Contract Number: H3370 Legal Entity Name: EMPIRE HEALTHCHOICE HMO, INC.

Organization Marketing Name: Empire BlueCross BlueShield HMO Parent Organization: Wellpoint, Inc.







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.


257 West Genesee Street

BUFFALO NY 14202




City: State:

Zip:


Enrollment: 36,114


Division Mgr, Commercial Gov't Programs

1-518-220-4699

[email protected] 30 Century Hill Drive

Latham NY 12110 12/3/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Linda Warren


Contract Number: H3387 Legal Entity Name: UNITEDHEALTHCARE OF NEW YORK, INC.

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

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/1999 Contract Effective Date: 1-800-493-4647 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 821 [email protected] Email: 7 HANOVER SQUARE Address:

7 HANOVER SQUARE Legal Entity Address: 5TH FLOOR New York City: NEW YORK City: NYState: NYState: 10007Zip: 10004 Zip: 5/8/2008Last Updated:

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: 20,973 [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

Organization Type: Local CCP Contact Title: Call Center support Plan Type: Local PPO 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: 27105 Last Updated: 2/5/2009










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

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: 97 [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:





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


5660 University Parkway

WINSTON-SALEM NC 271167509

For Profit Atlanta



City: State:

Zip:


Enrollment: 40,301


Call Center support

1-888-296-9790

[email protected] 5660 University Pkwy

Winston Salem NC 27105 2/5/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Provider Services


Contract Number: H3456 Legal Entity Name: UNITEDHEALTHCARE OF NORTH CAROLINA, INC.




3803 N Elm Street Legal Entity Address: CA124-0142 CyressCity:


Contract Number: H3493 Legal Entity Name: LIFE AT LOURDES, INC.

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

National PACE Organization Type: Director of Marketing Contact Title: National PACE Plan Type: Name: Tangela Thompson 5/1/2009 Contract Effective Date: 1-856-675-3674 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: 1-856-675-3659 Fax:

Enrollment: 14 [email protected] Email: 2475 McClellan Avenue Address:

2475 McClellan Ave., Bldg C Legal Entity Address: Building C Pennsauken City:

Pennsauken City: NJState: NJState: 08109Zip: 08109 Zip: 6/9/2009Last Updated:

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: 473 [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

Organization Type: PFFS Contact Title: Manager B - Contact SFl Plan Type: PFFS Name: Martha Garcia



Address: 8400 NW 33rd St Legal Entity Address: 4800 Deerwood Campus Parkway Suite 100

DCC 100, 8th Floor City: Miami City: Jacksonville State: FL




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 Contract Effective Date: 1/1/2008 Phone: 1-860-409-2400

Tax Status: For Profit Extension: CMS Region Responsible: New York Fax:

Enrollment: 15,583 Email: [email protected] Address: 175 Scott Swamp Road

Legal Entity Address: 175 Scott Swamp Road City: Farmington

City: Farmington State: CT State: CT Zip: 06032

Zip: 06032 Last Updated: 9/30/2007 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



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

Organization Type: National PACE Contact Title: Project Leader Plan Type: National PACE Name: Anne Messer



Address: 2373 Euclid Heights Blvd Legal Entity Address: 2373 EUCLID HEIGHTS BOULEVARD

City: Cleveland Heights City: CLEVELAND HEIGHTS State: OH



Contract Number: H3614 Legal Entity Name: TRIHEALTH SENIORLINK

Organization Marketing Name: Trihealth Seniorlink Parent Organization: TriHealth SeniorLink

National PACE Organization Type: Marketing/Intake coordinator Contact Title: National PACE Plan Type: Jayne MillerName: 11/1/2002 Contract Effective Date: 1-513-675-5270 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-513-569-6740 Fax:

Enrollment: 372 [email protected] Email: 619 Oak Street Address:

4750 WESLEY AVENUE Legal Entity Address: SUITE J CincinnatiCity: CINCINNATI City: OHState: OHState: 45206Zip: 45212 Zip: 9/12/2006Last Updated:







Contract Number: H3620 Legal Entity Name: MCKINLEY LIFE INSURANCE COMPANY

Organization Marketing Name: PrimeTime Health Plan Parent Organization: McKinley Life Insurance Company

Organization Type: Local CCP Contact Title: Compliance Coordinator Plan Type: Local PPO Name: Christine Cunningham



Address: 214 Dartmouth Avenue SW Legal Entity Address: 214 DARTMOUTH AVENUE S.W.

City: Canton City: CANTON State: OH


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

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



Address: 1901 Indian Wood Circle Legal Entity Address: 1901 INDIAN WOOD CIRCLE

City: Maumee City: Maumee State: OH


Contract Number: H3655 Legal Entity Name: COMMUNITY INSURANCE COMPANY








Contract Number: H3659 Legal Entity Name: UNITEDHEALTHCARE OF OHIO, INC.





Address: 5757 Plaza Dr Legal Entity Address: 9200 WORTHINGTON ROAD CA124-0142

City: Cyress City: WESTERVILLE State: CA



Contract Number: H3660 Legal Entity Name: SUMMACARE INC.

Organization Marketing Name: SummaCare Parent Organization: Summa Health System

Local CCP Organization Type: Director of Marketing Contact Title: HMO/HMOPOS Plan Type: Name: Tracie kinaitis 6/1/1996 Contract Effective Date: 1-330-996-8670 Phone: For Profit Tax Status: 62168Extension: Chicago CMS Region Responsible: 1-330-996-8866 Fax:

Enrollment: 18,910 [email protected] Email: 10 North Main Street Address:

P. O. Box 3620 Legal Entity Address: 10 North Main Steet AkronCity: AKRON City: OHState: OHState: 44308Zip: 44308 Zip: 2/9/2009Last Updated:



Local CCP Organization Type: Compliance Coordinator Contact Title: HMO/HMOPOS Plan Type: Christine Cunningham Name: 1/1/1997 Contract Effective Date: 1-800-577-5084 Phone: For Profit Tax Status: 34917Extension: Chicago CMS Region Responsible: 1-330-363-3066 Fax:

Enrollment: 17,303 [email protected] Email: 214 Dartmouth Avenue SW Address:

2600 SIXTH STREET SW Legal Entity Address: CantonCity:

CANTON City: OHState: OHState: 44710Zip: 44710 Zip: 6/22/2007Last Updated:

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: 27,542 [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


52160 National Road East

St. Clairsville OH 43950




City: State:

Zip:


Enrollment: 8,433


Director Member Services

1-740-695-7682

1-740-695-8103 [email protected] The Health Plan 52160 National Road East St. Clairsville OH 43950 8/23/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Sherry Stanley



Legal Entity Name: GLOBALHEALTH, INC.Organization Marketing Name: Universal American

Parent Organization: Universal American Corp.Organization Type: Local CCP Contact Title: Member Service Representative


Tax Status: For Profit Extension: CMS Region Responsible: Dallas Fax:

Enrollment: 7,907 Email: [email protected] Address: 4888 Loop Central Drive

Legal Entity Address: 4888 Loop Central Drive Suite 900 SUITE 700 City: Houston

City: Houston State: TX State: TX Zip: 77081

Zip: 77081 Last Updated: 6/17/2009 Contract Number: H3708 Legal Entity Name: SELECTCARE OF OKLAHOMA, 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



Organization Marketing Name: HISC - Blue Cross And Blue Shield Of Oklahoma Parent Organization: Health Care Service Corporation

Organization Type: Local CCP Contact Title: Director of Customer Service Plan Type: Local PPO Name: Pat Hall



Address: 218 W 6th Street Legal Entity Address: 901 South Central Expressway, North Building

City: Tulsa City: Richardson State: OK


Contract Number: H3749 Legal Entity Name: PACIFICARE OF OKLAHOMA, INC.





Address: 5757 Plaza Dr Legal Entity Address: 7666 E 61ST, #500 CA124-0142

City: Cyress City: TULSA State: CA

State: OK Zip: 90630 Zip: 74133 Last Updated: 4/14/2009


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: 26,641 [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:

Contract Number: H3805 Legal Entity Name: PACIFICARE OF OREGON, 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: 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: 815 [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


740 SE 7th Street

GRANTS PASS OR 97526

For Profit Seattle



City: State:

Zip:


Enrollment: 5,321



1-888-460-0185

1-541-471-1524 [email protected] 740 SE 7th Street

Grants Pass OR 97526 9/20/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Freddy Sennhauser


Contract Number: H3811 Legal Entity Name: SAMARITAN HEALTH PLANS, INC.

Organization Marketing Name: Samaritan Advantage Health Plan Parent Organization: Samaritan Health Services

Local CCP Organization Type: Marketing Manager Contact Title: HMO/HMOPOS Plan Type: Name: Cristie Lynch 6/1/2005 Contract Effective Date: 1-541-768-4552 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Seattle CMS Region Responsible: 1-541-768-4294 Fax:

Enrollment: 4,926 [email protected] Email: 815 NW 9th Street Address:

815 NW 9TH STREET, SUITE 103 Legal Entity Address: Suite 101 3600 NW Samaritan Dr. CorvallisCity: CORVALLIS City: ORState: ORState: 97330Zip: 97330 Zip: 7/21/2008Last Updated:





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

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


500 SE CASS AVE Suite 230 ROSEBURG OR 97470

For Profit Seattle



City: State:

Zip:


Enrollment: 3,821


Marketing Manager

1-541-672-8620 5386 1-541-672-8670 [email protected] 500 SE Cass Ave. Suite 230 Roseburg OR 97470 2/20/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Rose Novak


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 Legal Entity Address: 201 High Street SE SeattleCity: SALEM City: WAState: ORState: 98101-1322 Zip: 97309 Zip: 12/17/2008Last Updated:

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: 2,354 [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.


2965 NE Conners Ave.

BEND OR 97701

For Profit Seattle



City: State:

Zip:


Enrollment: 10,574


Medicare Marketing Manager

1-541-385-5315

1-541-385-3008 [email protected] 2965 NE Conners Ave.

Bend OR 97701 7/10/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Brad WestphalName:






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: H3907 Legal Entity Name: UNIVERSITY OF PITTSBURGH MEDICAL CENTER


Local CCP Organization Type: Medicare Hotline Contact Title: HMO/HMOPOS Plan Type: UPMC Health PlanName: 1/1/2001 Contract Effective Date: 1-877-381-3765 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:


ONE CHATHAM CENTER Legal Entity Address: 112 WASHINGTON PLACE PittsburghCity: PITTSBURGH City: PAState: PAState: 15219Zip: 15219 Zip: 9/1/2006Last Updated:

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


4508 Chestnut Street

PHILADELPHIA PA 19139




City: State:

Zip:


Enrollment: 346


QCC INSURANCE COMPANY H3909


Organization Marketing Name: Personal Choice 65 Independence Blue Cross Parent Organization: Local CCP Local PPO 1/1/2002

1901 MARKET STREET 28TH FLOOR PHILADELPHIA PA 191031480




City: State:

Zip:


Enrollment: 14,748


Executive Director

1-215-898-4417

[email protected] 4508 Chestnut Street

Philadelphia PA 19139 5/21/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Wayne Pendelton Name:

1-800-331-0017

[email protected] 1901 Market Street

Philadelphia PA 19103 9/6/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Plan Inquiries







Contract Number: H3916 Legal Entity Name: HIGHMARK, INC.

Organization Marketing Name: Highmark Inc. Parent Organization: Highmark Inc.

Local CCP Organization Type: VP, Sr. Products Operations Contact Title: Local PPO Plan Type: Name: Sally Rich 5/1/2003 Contract Effective Date: 1-412-544-3186 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 84,543 [email protected] Email: 120 Fifth Avenue Address:

FIFTH AVENUE PLACE - SUITE P5501 Legal Entity Address: Suite P5501 120 FIFTH AVENUE PittsburghCity: PITTSBURGH City: PAState: PAState: 15222Zip: 15222 Zip: 8/21/2006Last Updated:

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: 305 [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


875 Greentree Road. One Parkway Center, Suite 200 PITTSBURGH PA 15220




City: State:

Zip:


Enrollment: 323


Director of Finance

1-412-388-8042 8042 1-412-388-8055 [email protected] 875 Greentree Rd, One Parkway Center, Suite 200

Pittsburgh PA 15220 9/12/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Laura Schmitt


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.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services Dept 4/1/2005 Contract Effective Date: 1-800-290-4009 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 17,272 [email protected] Email: Unison Plaza Address:

1001 Brinton Road Legal Entity Address: 1001 Brinton Road PittsburghCity:

Pittsburgh City: PAState: PAState: 15221Zip: 15221 Zip: 12/3/2007Last Updated:





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


2500 ELMERTON AVENUE

HARRISBURG PA 17177




City: State:

Zip:


Enrollment: 9,683


Customer Service Manager

1-800-779-6962

[email protected] 2500 Elmerton Avenue

Harrisburg PA 17177 5/27/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Jayne DaileyName:


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: 1,312 [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.

National PACE Organization Type: Cheif Executive Officer Contact Title: National PACE Plan Type: Mark IrwinName: 11/1/2007 Contract Effective Date: 1-814-535-6000 Phone: For Profit Tax Status: 101Extension: Philadelphia CMS Region Responsible: 1-814-248-7902 Fax:

Enrollment: 152 [email protected] Email: 401 Broad Street Address:

209 Sigma Drive Legal Entity Address: Johnstown City:


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.


1950 Amphitheater Drive

Wilmington NC 28401




City: State:

Zip:


Enrollment: 25


CFO / PACE PROGRAM DIRECTOR

1-910-343-8209

1-910-343-8836 [email protected] 1950 Amphitheater Dr.

Wilmington NC 28401 9/9/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Larry Reinhart


Contract Number: H3949 Legal Entity Name: BRAVO HEALTH PENNSYLVANIA INC.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 2/1/1992 Contract Effective Date: 1-800-291-0396 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 19,119 [email protected] Email: 3601 O'Donnell Street Address:

1500 Spring Garden Street, Suite 800 Legal Entity Address: Baltimore City:

PHILADELPHIA City: MDState: PAState: 21224Zip: 19130 Zip: 8/23/2007Last Updated:

Contract Number: H3952 Legal Entity Name: KEYSTONE HEALTH PLAN EAST, INC.

Organization Marketing Name: Keystone 65 Parent Organization: Independence Blue Cross

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Plan Inquiries 1/1/1993 Contract Effective Date: 1-800-331-0017 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 122,649 [email protected] Email: 1901 Market Street Address:

1901 MARKET STREET Legal Entity Address: 45TH FLOOR PhilaCity: PHILADELPHIA City: PAState: PAState: 19103Zip: 19103 Zip: 9/6/2007Last Updated:

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:


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.


120 5TH AVENUE SUITE 3152 PITTSBURGH PA 152223099




City: State:

Zip:


Enrollment: 169,749


VP, Sr. Products Operations

1-412-544-3186

[email protected] 120 Fifth Avenue Suite P5501 Pittsburgh PA 15222 8/31/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Sally Rich


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


CMS Region Responsible: Philadelphia Fax: Enrollment: 17,769 Email: [email protected]

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.


350 Chardon Ave Suite 500 Torre Chardon San Juan PR 009182137

For Profit New York



City: State:

Zip:


Enrollment: 130,991


Provider AVP

1-787-622-3000 6703 1-787-622-0485 [email protected] 350 Avenida Chard≤n Torre Chard≤n, Suite 500 San Juan PR 00918-2137 5/9/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Brenda RiveraName:



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: 52,620 [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

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



Address: 1441 Franklin D. Roosevelt Ave. Legal Entity Address: PO BOX 363628

City: San Juan City: SAN JUAN State: PR


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.




Address: 101 East Main Street Legal Entity Address: 383 F.D. Roosevelt Avenue, 3rd Floor

City: Louisville City: San Juan State: KY



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.

Local CCP Organization Type: Director of Medicare Programs & Compliance Contact Title: HMO/HMOPOS Plan Type: Name: Hector L Feliciano 9/1/2005 Contract Effective Date: 1-787-999-4797 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: 1-787-999-6560 Fax:


28 Calle Santa Cruz Legal Entity Address: BayamonCity:

Bayam≤nCity: PRState: PRState: 00960-3078 Zip: 00960 Zip: 4/7/2009Last Updated:

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



Contract Number: H4012 Legal Entity Name: TRIPLE-S SALUD, INC.

Organization Marketing Name: Triple-S Salud, Inc. Parent Organization: Triple-S Management Corporation


PO BOX 363628 1441 AVE ROOSEVELT SAN JUAN PR 009363628

For Profit New York



City: State:

Zip:


Enrollment: 23,248



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: H4102 Legal Entity Name: UNITEDHEALTHCARE OF NEW ENGLAND, INC.




3803 N ELM ST Legal Entity Address: CA124-0142 CyressCity:


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

Organization Type: National PACE Contact Title: CEO Plan Type: National PACE Name: Joan L Kwiatkowski



Address: 225 Chapman Street, Box 7 Legal Entity Address: 225 CHAPMAN STREET

City: Providence City: PROVIDENCE State: RI

State: RI Zip: 02905 Zip: 02905 Last Updated: 4/16/2009






Address: 5757 Plaza Dr Legal Entity Address: 475 KILVERT STREET CA124-0142

SUITE 310 City: Cyress City: WARWICK State: CA

State: RI Zip: 90630 Zip: 028861392 Last Updated: 4/14/2009


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: 882 [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

National PACE Organization Type: Finance Director Contact Title: National PACE Plan Type: Thelma Pittman Name: 8/1/2008 Contract Effective Date: 1-918-207-4936 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-918-431-4112 Fax:

Enrollment: 28 [email protected] Email: 1387 W 4th St. Address:

1387 W 4th St. Legal Entity Address: TahlequahCity:

Tahlequah City: OKState: OKState: 74464Zip: 74464 Zip: 3/6/2008Last Updated:

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: 39,712 [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

Organization Type: National PACE Contact Title: Administrative Coordinator Intake Plan Type: National PACE Name: Shirley Gregg


CMS Region Responsible: Atlanta Fax: 1-803-931-8164 Enrollment: 337 Email: [email protected]

Address: 1308 Laureo Street Legal Entity Address: 15 RICHLAND MEDICAL PARK DRIVE

SUITE 203 City: Columbia City: COLUMBIA State: SC

State: SC Zip: 29201 Zip: 29203 Last Updated: 8/21/2006


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


Contract Number: H4205 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: PFFS Contact Title: Manager - Enrollment and Billing Plan Type: PFFS Name: Keyla Clark



Address: 4101 Percival Road Legal Entity Address: 2501 Faraway Drive AX-G07

City: Columbia City: COLUMBIA State: SC


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.



500 Stinson Boulevard NE

Minneapolis MN 55413




City: State:

Zip:


Enrollment: 2,873


Medicare Customer Services Supervisor

1-612-676-3471



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Vatisha Hammick


Contract Number: H4305 Legal Entity Name: TOTAL LIFE HEALTHCARE

Organization Marketing Name: Total Life Healthcare Parent Organization: St. Bernard's Healthcare

National PACE Organization Type: Finance Manager Contact Title: National PACE Plan Type: Name: Terry Combs 6/1/2008 Contract Effective Date: 1-870-336-5004 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-870-336-5001 Fax:

Enrollment: 23 [email protected] Email: 225 East Jackson #92 Address:

225 East Jackson #92 Legal Entity Address: Jonesboro City:

Jonesboro City: ARState: ARState: 72401Zip: 72401 Zip: 4/30/2008Last Updated:





151 Farmington avenue Legal Entity Address: Hartford City:


Contract Number: H4402 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: IT Plan Type: National PACE Name: Jon Gabert



Address: 425 Cumberland Street Legal Entity Address: 425 CUMBERLAND STREET Suite 110

Suite 110 City: Chattanooga City: CHATTANOOGA State: TN


Contract Number: H4406 Legal Entity Name: UNITEDHEALTHCARE OF TENNESSEE, INC.






MAIL ROUTE MN008-W140 City: Cyress City: MINNETONKA State: CA




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.


44 VANTAGE WAY, SUITE 300

NASHVILLE TN 37228

For Profit Denver



City: State:

Zip:


Enrollment: 56,070



1-832-553-3300 3379


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendy Wetzel


Contract Number: H4456 Legal Entity Name: UNITEDHEALTHCARE OF THE RIVER VALLEY, INC.




1300 River Drive, Suite 200 Legal Entity Address: CA124-0142 CyressCity:

MolineCity: CAState: ILState: 90630Zip: 61265 Zip: 4/14/2009Last Updated:

Contract Number: H4461 Legal Entity Name: CARITEN HEALTH PLAN IN

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



500 West Main St Legal Entity Address: LouisvilleCity:


Contract Number: H4506 Legal Entity Name: SELECTCARE OF TEXAS, L.L.C.


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 300 City: Houston City: Houston State: TX


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.




Address: 101 East Main Street Legal Entity Address: 1221 South Mopac, Suite 200

City: Louisville City: Austin State: KY



Contract Number: H4513 Legal Entity Name: TEXAS HEALTHSPRING LLC

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

Local CCP Organization Type: Vice President of Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Wendy Wetzel 3/1/2001 Contract Effective Date: 1-832-553-3300 Phone: For Profit Tax Status: 3379Extension: Denver CMS Region Responsible: 1-832-553-3400 Fax:

Enrollment: 48,450 [email protected] Email: 2900 North Loop West Suite 1300 Address:

2900 N LOOP WEST, SUITE 1300 Legal Entity Address: HoustonCity:

HOUSTON City: TXState: TXState: 77092Zip: 77092 Zip: 12/17/2008Last Updated:

Contract Number: H4514 Legal Entity Name: EVERCARE OF TEXAS, LLC




9900 BREN ROAD EAST Legal Entity Address: CA124-0142 MN 008-W130 CyressCity: MINNETONKA City: CAState: MNState: 90630Zip: 55343 Zip: 4/14/2009Last Updated:

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: 127 [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


2300 McKinley

EL PASO TX 79930

Not-for-Profit/Non-Profit Dallas



City: State:

Zip:


Enrollment: 689


Chief Operations Officer

1-915-562-3444 2290

[email protected] 2300 McKinley

El Paso TX 79930 9/13/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Margie Murphy








Contract Number: H4521 Legal Entity Name: TEXAS HEALTH SPRING LLC

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

Local CCP Organization Type: Vice President of Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Wendy Wetzel 6/1/2005 Contract Effective Date: 1-832-553-3300 Phone: For Profit Tax Status: 3379Extension: Denver CMS Region Responsible: 1-832-553-3400 Fax:

Enrollment: 321 [email protected] Email: 2900 North Loop West Suite 1300 Address:

2900 N LOOP WEST, SUITE 1300 Legal Entity Address: HoustonCity:

HOUSTON City: TXState: TXState: 77092Zip: 77092 Zip: 2/5/2009Last Updated:














Address: 151 Farmington Avenue Legal Entity Address: 2777 Stemmons Freeway Suite 400

City: Hartford City: Dallas State: CT









Contract Number: H4525 Legal Entity Name: SHA, L.L.C

Organization Marketing Name: FirstCare Advantage Parent Organization: Covenant Health System - Hendrick Health System

Local CCP Organization Type: Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Customer Service 7/1/2005 Contract Effective Date: 1-866-229-4969 Phone: For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-806-784-4190 Fax:

Enrollment: 2,014 [email protected] Email: 1901 West Loop 289, Suite 9 Address:

12940 North Highway 183Legal Entity Address: LubbockCity:

AustinCity: TXState: TXState: 79407Zip: 78750 Zip: 5/26/2009Last Updated:

Contract Number: H4527 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF TEXAS LLC

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: 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.

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:


825 WASHINGTON STREET, SUITE 300 Legal Entity Address: OaklandCity:



Organization Marketing Name: HISC - Blue Cross Blue Shield of Texas 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:

Enrollment: 832 [email protected] Email: P.O. Box 3567 Address:

901 South Central Expressway, North BuildingLegal Entity Address: ScrantonCity:

Richardson City: PAState: TXState: 18503Zip: 75080 Zip: 8/22/2006Last Updated:

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: Seattle CMS Region Responsible: Fax:

Enrollment: 4,979 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 1876 Cost 4/1/1996

2401 SOUTH 31ST STREET

TEMPLE TX 76508




City: State:

Zip:


Enrollment: 23,601


Call Center

1-866-344-3141

[email protected] 2401 South 31st Street

Temple TX 76508 8/21/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H4577 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ILLINOIS, 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: 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 201 High Street SE Salem OR 97309

Not-for-Profit/Non-Profit Seattle



City: State:

Zip:


Enrollment: 22,361


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: 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 Organization Type: Manager of Customer Services Contact Title: HCPP - 1833 Cost Plan Type: Name: Deeann Benson 12/1/1993 Contract Effective Date: 1-801-595-4309 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Denver CMS Region Responsible: 1-801-595-2009 Fax:

Enrollment: 11,584 [email protected] Email: 1040 N 2200 W Suite 200 Address:

1040 N 2200 W Suite 200 Legal Entity Address: Salt Lake CityCity:

Salt Lake CityCity: UTState: UTState: 84116Zip: 84116 Zip: 8/25/2008Last Updated:

Contract Number: H4720 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK

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: C/O Ovations, SRS, 9900 Bren Road East, MN008-T44 CA124-0142





Organization Type: Demo Contact Title: Plan Type: Continuing Care Retirement Community Name: Richard Irwin



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

MN008-T440 City: Cyress City: Minnetonka State: CA









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 Organization Type: Manager, Performance Group Call Center Contact Title: PFFS Plan Type: Name: Nancy Peebles 1/1/2008 Contract Effective Date: 1-800-982-3117 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 1,455 [email protected] Email: 2060 East Ninth Street Address:

2060 East 9th Street Legal Entity Address: ClevelandCity:

Cleveland City: OHState: OHState: 44115Zip: 44115 Zip: 2/27/2009Last Updated:

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: 34 [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

Organization Type: HCPP - 1833 Cost Contact Title: Dues Clerk Plan Type: HCPP - 1833 Cost Name: Margaret Brown


CMS Region Responsible: Philadelphia Fax: 1-540-862-4958 Enrollment: 2,842 Email: [email protected]

Address: 511 Main Street, 2nd Floor Legal Entity Address: 511 MAIN STREET, 2ND FLOOR

City: Clifton Forge City: CLIFTON FORGE State: VA

State: VA Zip: 24422 Zip: 24422 Last Updated: 9/28/2007


Contract Number: H4908 Legal Entity Name: OPTIMA HEALTH INSURANCE COMPANY

Organization Marketing Name: Optima Medicare Parent Organization: Sentara Healthcare

Local CCP Organization Type: Director, Customer Service Contact Title: Local PPO Plan Type: Ydsia N SlagleName: 9/1/2005 Contract Effective Date: 1-800-927-6048 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 4,660 [email protected] Email: 4417 Corporation Lane Address:

4417 CORPORATION LANELegal Entity Address: Virginia Beach City:

VIRGINIA BEACH City: VAState: VAState: 23462Zip: 23462 Zip: 8/23/2006Last Updated:

Contract Number: H4909 Legal Entity Name: ANTHEM HEALTH PLANS OF VIRGINIA, INC.













Address: 151 Farmington Avenue Legal Entity Address: 1302 Concourse Drive

City: Hartford City: Linthicum State: CT











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






110 Employers Blvd. Legal Entity Address: LouisvilleCity:






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: H4979 Legal Entity Name: BLUECROSS BLUESHIELD OF TENNESSEE

Organization Marketing Name: BlueCross BlueShield of Tennessee Parent Organization: BlueCross BlueShield of Tennessee

PFFS PFFS 1/1/2009

801 Pine Street

Chattanooga TN 37402




City: State:

Zip:


Enrollment: 1,822


Supervisor Medicare Advantage Operations

1-800-841-7434

[email protected] 801 Pine Street

Chattanooga TN 37402 12/27/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Carol Troxell


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

Organization Type: PFFS Contact Title: Customer Service Manager Plan Type: PFFS Name: Wendi Western



Address: 2219 Rimland Drive Legal Entity Address: 2219 Rimland Drive PO Box 5348

P.O. BOX 5348 City: Bellingham City: BELLINGHAM State: WA

State: WA Zip: 98227-5348 Zip: 982275348 Last Updated: 7/25/2008

Contract Number: H5007 Legal Entity Name: PROVIDENCE HEALTH SYSTEM

Organization Marketing Name: Providence Health System Parent Organization: Providence Health System

Organization Type: National PACE Contact Title: Administrative Services Manager Plan Type: National PACE Name: Kathy Mellecker


CMS Region Responsible: Seattle Fax: 1-206-760-6339 Enrollment: 309 Email: [email protected]

Address: 4515 Martin Luther King Jr. Way S. Ste. 100 Legal Entity Address: 4515 MARTIN LUTHER KING JR.WAY SOUTH STE 10

City: Seattle City: SEATTLE State: WA

State: WA Zip: 98108 Zip: 98108 Last Updated: 6/12/2009










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 Legal Entity Address: 201 High Street SE SeattleCity: Salem City: WAState: ORState: 98101-1322 Zip: 97309 Zip: 12/15/2008Last Updated:

Contract Number: H5031 Legal Entity Name: DAVITA VILLAGEHEALTH OF DC, INC.

Organization Marketing Name: DaVita VillageHealth of DC, Inc. Parent Organization: Davita Inc

Organization Type: Local CCP Contact Title: Sr Manager, Marketing Operations and Communication Plan Type: Local PPO Name: Teri Hunt


CMS Region Responsible: Denver Fax: 1-303-626-6384 Enrollment: 21 Email: [email protected]

Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway

Suite 410 City: Lakewood City: Vernon Hills State: CO


Contract Number: H5037 Legal Entity Name: MOUNTAIN EMPIRE OLDER CITIZENS, INCX.

Organization Marketing Name: Mountain Empire PACE Parent Organization: Mountain Empire Older Citizens, Inc

Organization Type: National PACE Contact Title: Plan Type: National PACE Name: Tony Lawson



Address: P. O. Box 888 Legal Entity Address: 1501 Third Avenue East

P.O. Box 888 City: Big Stone Gap City: Big Stone Gap State: VA









Contract Number: H5042 Legal Entity Name: CDPHP UNIVERSAL BENEFITS, INC.

Organization Marketing Name: CDPHP Medicare Choices Parent Organization: Capital District Physicians' Health Plan, Inc.

Local CCP Organization Type: Manager, Member Services Contact Title: Local PPO Plan Type: Name: Laura Kordas 1/1/2008 Contract Effective Date: 1-518-641-3710 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 2,430 [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: 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



Legal Entity Name: EASY CHOICE HEALTH PLAN INC.Organization Marketing Name: Easy Choice Health Plan

Parent Organization: Easy Choice Health Plan Inc.Local CCP HMO/HMOPOS 1/1/2008

20411 S.W. Birch Street Suite 200 Newport Beach CA 92660

For Profit Seattle



City: State:

Zip:


Enrollment: 3,468


Enrollment and Customer Service Department

1-866-999-3945

1-877-999-3945 [email protected] 20411 S.W. Birch Street Suite 200 Newport Beach CA 92660 8/25/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



Contract Number: H5106 Legal Entity Name: HIGHMARK HEALTH INSURANCE COMPANY

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

Local CCP Organization Type: VP, Sr. Products Operations Contact Title: Local PPO Plan Type: Name: Sally Rich 7/1/2005 Contract Effective Date: 1-412-544-3186 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:


120 Fifth AvenueLegal Entity Address: P5501 PittsburghCity:

Pittsburgh City: PAState: PAState: 15222-3099 Zip: 15222 Zip: 2/28/2007Last Updated:







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: 9,875 [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


2335 Robinson Street

Colorado Springs CO 80904




City: State:

Zip:


Enrollment: 25


PACE Site Director

1-719-314-2327 335 1-719-457-0766 [email protected] 2335 Robinson Street

Colorado Springs CO 80904 2/8/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Kris Abbott


Contract Number: H5179 Legal Entity Name: CIGNA HEALTHCARE OF ARIZONA, INC.

Organization Marketing Name: CIGNA Medicare Access Parent Organization: CIGNA

PFFS Organization Type: Contact Title: PFFS Plan Type: Name: Medicare Team 1/1/2008 Contract Effective Date: 1-800-627-7534 Phone: For Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:

Enrollment: 348 [email protected] Email: Medicare Team Address:

11001 N. Black Canyon Highway Legal Entity Address: P.O. Box 42005 PhoenixCity:

Phoenix City: AZState: AZState: 85080Zip: 85029 Zip: 2/23/2007Last Updated:



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



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: 1,657 [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



1555 S. Layton Blvd.

Milwaukee WI 53215




City: State:

Zip:


Enrollment: 224


Director of Corporate Services

1-414-902-2364

[email protected] 1555 S. Layton Blvd.

Milwaukee WI 53215 6/8/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Becky Horn


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.


Enrollment: 867 [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.

Local CCP Organization Type: Customer Service Manager Contact Title: HMO/HMOPOS Plan Type: Name: Ken Baur 8/1/2002 Contract Effective Date: 1-897-998-0998 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-715-221-9500 Fax:

Enrollment: 22,101 [email protected] Email: 1515 Saint Joseph Avenue Address:

1515 SAINT JOSEPH AVENUE Legal Entity Address: PO Box 8000 PO Box 8000 Marshfield City: MARSHFIELD City: WIState: WIState: 54449-8000 Zip: 54449 Zip: 5/19/2008Last Updated:

Contract Number: H5212 Legal Entity Name: COMMUNITY CARE, INC.


Organization Type: National PACE Contact Title: Director of Corporate Services Plan Type: National PACE Name: Becky Horn



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

City: Milwaukee City: Milwaukee State: WI


Contract Number: H5213 Legal Entity Name: TOTAL COMMUNITY CARE, L.L.C.

Organization Marketing Name: Total Community Care Parent Organization: Total Community Care,LLC


904 A LAS LOMAS N.E.

Albuquerque NM 87102




City: State:

Zip:


Enrollment: 361


AVP Medicare and Medicaid Compliance

1-303-869-4664

1-303-996-1600 [email protected] 200 E. 9th Ave.

Denver CO 80203 9/25/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Matthew Zimmerman Name:








Contract Number: H5215 Legal Entity Name: NETWORK HEALTH INSURANCE CORPORATION

Organization Marketing Name: Network Health Insurance Corp. MA Plans Parent Organization: Affinity Health System

Organization Type: Local CCP Contact Title: VP Medicare Products Plan Type: Local PPO Name: Marcia Broeren



Address: 1570 Midway Place Legal Entity Address: 1570 MIDWAY PLACE P.O. Box 120

P.O. Box 120 City: Menasha City: MENASHA State: WI










Organization Type:Plan Type:

Contract Effective Date:Tax Status:

CMS Region Responsible:Enrollment:


City:State:

Zip:

PFFS PFFS 1/1/2007 For Profit Denver 136,885

6705 Rockledge Drive Suite 900

Bethesda MD 20817

Contact Title: Customer Service Name: Advantra Freedom

Phone: 1-866-386-2330 Extension:

Fax: Email: [email protected]

Address: Advantra Freedom/Coventry Health Care, Inc PO Box 7154

City: London 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

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: Not-for-Profit/Non-Profit Tax Status: Extension: Kansas CityCMS Region Responsible: 1-563-556-5134 Fax:

Enrollment: 2,585 [email protected] Email: 1605 Associates Drive, Suite 101 Address:

1605 ASSOCIATES DRIVE, Suite 101 Legal Entity Address: Dubuque City:

DUBUQUE City: IAState: IAState: 52001Zip: 52001 Zip: 8/21/2006Last Updated:

Contract Number: H5262 Legal Entity Name: GUNDERSEN LUTHERAN HEALTH PLAN

Organization Marketing Name: Gundersen Lutheran Health Plan, Inc. Parent Organization: Gunderson Lutheran, Inc.


3190 Gundersen Drive

Onalaska WI 54650




City: State:

Zip:


Enrollment: 11,119


DEAN HEALTH PLAN, INC. H5264


Organization Marketing Name: Dean Health Plan, Inc. Parent Organization: Dean Health Systems Inc.

1876 Cost 1876 Cost 1/1/1999

1277 DEMING WAY

MADISON WI 53717

For Profit Chicago



City: State:

Zip:


Enrollment: 12,694


1-800-394-5566 58077 1-608-775-8091 [email protected] 1900 South Avenue Mailstop: NCA2-01 La Crosse WI 54601 8/21/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


1-608-827-4131

[email protected] 1277 Deming Way

Madison WI 53717 8/14/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Mike Fox


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

Local CCP Organization Type: Project Manager Contact Title: HMO/HMOPOS Plan Type: Name: Janice Albert 1/1/2009 Contract Effective Date: Phone: 1-787-620-1414 For Profit Tax Status: Extension: New York CMS Region Responsible: 1-787-999-1250 Fax:

Enrollment: * Email: [email protected] PO BOX 364865 Address:

Metro Office Park 2 Calle 1 Suite 101 Legal Entity Address: Calle 1 Suite 101 San JuanCity: Guaynabo City: PRState: PRState: 00936Zip: 00968 Zip: 1/31/2008Last Updated:







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: Seattle CMS Region Responsible: Fax:

Enrollment: 125 [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


Organization Type: Demo Contact Title: Member Service Representative Plan Type: ESRD I - PFFS Name: Member Services



Address: 4888 Loop Central Drive Legal Entity Address: c/o HHS Texas Management Suite 900

4888 Loop Central Drive, Suite 800 City: Houston City: Houston State: TX



Contract Number: H5302 Legal Entity Name: COVENTRY HEALTH CARE OF GEORGIA, INC.

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

Local CCP Organization Type: Customer Service Contact Title: HMO/HMOPOS Plan Type: Name: Advantra Freedom 1/1/2007 Contract Effective Date: 1-800-296-1024 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 1,118 [email protected] Email: 3721 TecPort Dr, PO 67103 Address:

1100 Circle 75 Parkway Suite 1400 Legal Entity Address: Harrisburg City:

Atlanta City: PAState: GAState: 17106-7103 Zip: 30339 Zip: 8/24/2006Last Updated:

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 HEALTH SERVICES

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: 15 [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:





For Profit Dallas



City: State:

Zip:


Enrollment: 417



1-866-422-5009


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last 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

Organization Type: National PACE Contact Title: Information and Referral Specialist Plan Type: National PACE Name: Norine Bell



Address: 1333 Bush St. Legal Entity Address: 1333 BUSH STREET

City: San Francisco City: SAN FRANCISCO State: CA


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


510-17th St., Suite 400

OAKLAND CA 94612




City: State:

Zip:


Enrollment: 379


IT Manager

1-510-433-1160 8044 1-510-452-8836 [email protected] 510-17th St., Suite 400

Oakland CA 94612 3/4/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

David S VirgoName:


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: 202 [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.

Local CCP Organization Type: CIOContact Title: HMO/HMOPOS Plan Type: Name: Upen Patel 6/1/2004 Contract Effective Date: 1-813-490-8900 Phone: For Profit Tax Status: 8995Extension: Atlanta CMS Region Responsible: Fax:

Enrollment: 14,078 [email protected] Email: 5420 Bay Center Drive Address:

5420 BAY CENTER DRIVE Legal Entity Address: Suite 250 SUITE 250 TampaCity: TAMPA City: FLState: FLState: 33609Zip: 33609 Zip: 3/3/2009Last Updated:

Contract Number: H5410 Legal Entity Name: HEALTHSPRING OF FLORIDA, INC.

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


11401 SW 40 Street, Suite 400

MIAMI FL 33165

For Profit Denver



City: State:

Zip:


Enrollment: 30,976


AETNA HEALTH INC. H5414




4630 Woodlands Corporate Blvd.

Tampa FL 33614

For Profit Boston



City: State:

Zip:


Enrollment: 2,751



1-832-553-3300 3379


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Wendy Wetzel

1-800-445-1796


Hartford CT 06156 8/24/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last 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.



3501 SW 160th Avenue Legal Entity Address: LouisvilleCity:

Miramar City: KYState: FLState: 40202Zip: 33027 Zip: 8/22/2006Last Updated:


Organization Marketing Name: Spokane Community Care Parent Organization: Arcadian Management Services Inc.

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



OAKLAND City: CAState: WAState: 94607Zip: 94607 Zip: 2/26/2008Last Updated:




4350 WEST CYPRESS STREET SUITE 1000 TAMPA FL 33607




City: State:

Zip:


Enrollment: 29,632


BLUE CROSS OF CALIFORNIA H5419



PFFS PFFS 2/1/2005

1 WellPoint Way CAT201-C004 Thousand Oaks CA 90362

For Profit Chicago



City: State:

Zip:


Enrollment: 9,847


1-888-867-5518


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Richard IrwinName:

1-888-445-8916

[email protected] P.O. Box 9154

Oxnard CA 93031 7/13/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:




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: 16,076 [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:



Organization Type: PFFS Contact Title: Member Services Representative Plan Type: PFFS Name: Member Services






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: Member Services Plan Type: HMO/HMOPOS Name: Member Services



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.



3501 SW 160th Avenue Legal Entity Address: LouisvilleCity:

Miramar City: KYState: FLState: 40202Zip: 33027 Zip: 9/11/2008Last Updated:

Contract Number: H5427 Legal Entity Name: FREEDOM HEALTH PLAN, INC.

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

Organization Type: Local CCP Contact Title: Sr. VP Operations Plan Type: HMO/HMOPOS Name: Chris O'Connor



Address: 5403, Church Ave N, Legal Entity Address: 5403 N Church Avenue



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

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: CareAdvntg Unit



Address: 701 Gateway Blvd., Suite 400 Legal Entity Address: 701 GATEWAY BLVD., SUITE 400

City: South San Francisco City: SOUTH SAN FRANCISCO State: CA




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: 1,517 [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

Local CCP Organization Type: Compliance Officer Contact Title: HMO/HMOPOS Plan Type: Name: Cheyenne Hollin 9/1/2005 Contract Effective Date: 1-602-778-8345 Phone: For Profit Tax Status: 8318Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 1,548 [email protected] Email: 2355 E. Camelback Rd., Ste 300 Address:

2355 E. CAMELBACK ROAD, SUITE 300 Legal Entity Address: PhoenixCity:

PHOENIX City: AZState: AZState: 85016Zip: 85016 Zip: 10/8/2008Last Updated:

Contract Number: H5431 Legal Entity Name: HEALTHSUN HEALTH PLANS, INC.

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

Organization Type: Local CCP Contact Title: Vice President Plan Type: HMO/HMOPOS Name: Jonathan Klein



Address: 1205 SW 37th Avenue Legal Entity Address: 1205 SOUTHWEST 37TH AVENUE, 2ND FLOOR

City: Miami City: MIAMI State: FL


Contract Number: H5433 Legal Entity Name: ORANGE COUNTY HEALTH AUTHORITY

Organization Marketing Name: OneCare Parent Organization: CalOptima

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



Address: 1120 W. La Veta Avenue Legal Entity Address: 1120 WEST LA VETA AVENUE, 5TH FLOOR

City: Orange City: ORANGE State: CA



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

Local CCP Organization Type: Manager B - Contact SFlContact Title: Local PPO Plan Type: Name: Martha Garcia 8/1/2005 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: 13,228 [email protected] Email: 8400 NW 33rd St Address:

4800 DEERWOOD CAMPUS PARKWAY Legal Entity Address: Suite 100 MiamiCity:

JACKSONVILLE City: FLState: FLState: 33122Zip: 32246 Zip: 4/1/2009Last Updated:


Organization Marketing Name: SecureHorizons MedicareDirect Parent Organization: UnitedHealth Group, Inc.

PFFS Organization Type: Contact Title: PFFS Plan Type: Richard IrwinName: 9/1/2005 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: H5436 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



Address: AvMed Health Plans Legal Entity Address: 4300 N.W. 89th BLVD 4300 NW 89 Blvd.

City: Gainesville City: GAINESVILLE State: FL











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: 698 Email: [email protected]

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

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






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: H5449 Legal Entity Name: DAVITA VILLAGEHEALTH OF VIRGINIA, INC.

Organization Marketing Name: DaVita VillageHealth of Virginia, Inc. Parent Organization: Davita Inc

Organization Type: Local CCP Contact Title: Sr Manager, Marketing Operations and Communication Plan Type: Local PPO Name: Teri Hunt



Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway

Suite 410 City: Lakewood City: Vernon Hills State: CO






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







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

Local CCP Organization Type: Contact Title: Local PPO Plan Type: Name: Member Services 1/1/2006 Contract Effective Date: 1-800-631-8443 Phone: For Profit Tax Status: 2Extension: Dallas CMS Region Responsible: Fax:

Enrollment: 446 [email protected] Email: Three Lakeway Center Address:

Three Lakeway Center Legal Entity Address: 3838 N Causeway Blvd, Suite 2200 3838 N Causeway Blvd., Suite 2200 Metairie City: Metairie City: LAState: LAState: 70002Zip: 70002 Zip: 9/20/2006Last Updated:





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


9045 River Road, Suite 200

Indianapolis IN 46240

For Profit Chicago



City: State:

Zip:


Enrollment: 2,507


Manager of Marketing and Enrollment Strategies

1-317-573-7954

[email protected] 9045 River Road, Suite 200

Indianapolis IN 46240 10/23/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Cynthia Stepp


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.

Local CCP Organization Type: Manager, Medicare Compliance Contact Title: Local PPO Plan Type: Name: Gail D Howard-King 1/1/2006 Contract Effective Date: 1-800-280-7148 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 28,705 [email protected] Email: 8320 Ward Parkway Address:

500 Virginia Street, Suite 400 Legal Entity Address: Kansas CityCity:

Charleston City: MOState: WVState: 64114Zip: 25326 Zip: 12/3/2007Last Updated:


























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.



11 Stanwix Street

Pittsburgh PA 15222

For Profit Denver



City: State:

Zip:


Enrollment: 17,742


Director, Regulatory Compliance

1-800-470-4272

1-412-577-5416 [email protected] 11 Stanwix Street Suite 2300 Pittsburgh PA 15222 12/5/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Barbara Sellman Name:


Contract Number: H5523 Legal Entity Name: CARITEN INSURANCE COMPANY

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



500 West Main St Legal Entity Address: LouisvilleCity:


Contract Number: H5525 Legal Entity Name: HUMANA BENEFIT PLAN OF ILLINOIS, INC.

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





Contract Number: H5526 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



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

City: Latham City: Buffalo State: NY


Contract Number: H5528 Legal Entity Name: GROUP HEALTH INCORPORATED

Organization Marketing Name: GHI Medicare PPO Parent Organization: EmblemHealth Inc.


80 Wolf Road 6th Floor Albany NY 12206




City: State:

Zip:


Enrollment: 20,678


Manager Medicare Programs

1-866-557-7300

[email protected] 80 Wolf Road 6th Floor Albany NY 12205 2/18/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Peggy Fry


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:


112 Washington Place Legal Entity Address: PittsburghCity:


Contract Number: H5549 Legal Entity Name: VNS CHOICE

Organization Marketing Name: VNS CHOICE Medicare Parent Organization: Visiting Nurse Service of New York

Local CCP Organization Type: Director, Compliance and Regulatory Affairs Contact Title: HMO/HMOPOS Plan Type: Name: Karl Dehm 1/1/2007 Contract Effective Date: 1-866-783-1444 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 2,575 [email protected] Email: 1250 Broadway Address:

107 E 70th Street Legal Entity Address: 11th Floor New York City:

New York City: NYState: NYState: 10001Zip: 10021 Zip: 6/2/2008Last Updated:

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: 4,179 [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


9300 Harris Corners Parkway Suite 100 Charlotte NC 28269

For Profit Chicago



City: State:

Zip:


Enrollment: 435


Manager - Customer Services-Production

1-877-372-8085

[email protected] 201 Lackawanna Avenue

Scranton PA 18503 7/1/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Ron Rome



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 Contract Effective Date: 1/1/2007 Phone: 1-318-361-0900

Tax Status: For Profit Extension: 142 CMS Region Responsible: Dallas Fax: 1-318-361-2159

Enrollment: 3,623 Email: [email protected] Address: 130 DeSiard St

Legal Entity Address: 130 DeSiard St Suite 300 Suite 300 City: Monroe

City: Monroe State: LA State: LA Zip: 71201

Zip: 71201 Last Updated: 5/25/2008 Contract Number: H5577 Legal Entity Name: MCS ADVANTAGE INC.





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: H5578 Legal Entity Name: ARCADIAN HEALTH PLAN OF GEORGIA, INC.






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

State: AZ Zip: 85040 Zip: 85040 Last Updated: 10/13/2008


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: 3,580 [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.,


Enrollment: 365 [email protected] Email: 200 Oceangate Address:

7050 S. Union Park Center, Suite 200 Legal Entity Address: Ste. 100 Long Beach City:

MidvaleCity: CAState: UTState: 90802Zip: 84047 Zip: 2/19/2008Last Updated:

Contract Number: H5590 Legal Entity Name: BRIDGEWAY HEALTH SOLUTIONS

Organization Marketing Name: Advantage by Bridgeway Health Solutions Parent Organization: Centene Corporation

Organization Type: Local CCP Contact Title: Director Plan Type: HMO/HMOPOS Name: Elaine Teune



Address: 1501 W Fountainhead Parkway Legal Entity Address: 15101 West Fountainhead Parkway suite #201

City: Tempe City: Tempe State: AZ


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.

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Marketing Representative



Address: P. O. Box 9746 Legal Entity Address: P.O. Box 9746 891 Washington Avenue

331 Veranda Street City: Portland City: Portland State: ME

State: ME Zip: 04104 Zip: 04104 Last Updated: 8/23/2006


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: 4,561 [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

Organization Type: Demo Contact Title: Customer Service Manager Plan Type: ESRD I - PFFS Name: Wendi Western



Address: 2219 Rimland Drive Legal Entity Address: 2219 Rimland Drive PO Box 5348

PO Box 5348 City: Bellingham City: Bellingham State: WA


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: 2,662 [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


4550 California Avenue Suite 100 Bakersfield CA 933091669




City: State:

Zip:


Enrollment: 6,382


Marketing Manager

1-877-697-2464

[email protected] 4550 California Avenue Suite 100 Bakersfield CA 93309 10/10/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Ana Igoa



Legal Entity Name: CARE RESOURCES, INC.Organization Marketing Name: Care Resources

Parent Organization: CARE RESOURCES, INC.National PACE Organization Type: Claims Manager Contact Title: National PACE Plan Type: Name: Becky Haggerty 9/1/2006 Contract Effective Date: 1-616-956-9440 Phone: Not-for-Profit/Non-Profit Tax Status: 2178Extension: Chicago CMS Region Responsible: 1-616-285-2588 Fax:

Enrollment: 146 beckyh@hhs inc.com Email: 2100 Raybrook Ave SE Address:

1471 Grace Street SE Legal Entity Address: Suite 203 Grand Rapids City:

Grand Rapids City: MIState: MIState: 49546Zip: 49506 Zip: 4/3/2009Last Updated:


Organization Marketing Name: Northeast Community Care Parent Organization: Arcadian Management Services Inc.



825 Washington Street, Suite 300 Legal Entity Address: OaklandCity:

OaklandCity: CAState: CAState: 94607Zip: 94607 Zip: 2/28/2008Last Updated:

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


328 Maple Street

San Diego CA 92103




City: State:

Zip:


Enrollment: 60


Executive Director

1-619-239-6900

1-619-239-1256 [email protected] 328 Maple Street

San Diego CA 92103 1/23/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: John A Allgood


Contract Number: H5640 Legal Entity Name: IEHP HEALTH ACCESS

Organization Marketing Name: IEHP Medicare DualChoice Parent Organization: INLAND EMPIRE HEALTH PLAN




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




Address: 1540 Bridgegate Drive Legal Entity Address: 1540 Bridgegate Drive

City: Diamond Bar City: Diamond Bar State: CA






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


Contract Number: H5656 Legal Entity Name: SELECTCARE HEALTH PLANS, INC.



4888 Loop Central Drive Suite 800 Houston TX 77081

For Profit Dallas



City: State:

Zip:


Enrollment: 5,526


Member Service Representative

1-800-958-2707


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



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

Local CCP Organization Type: Marketing Manager Contact Title: HMO/HMOPOS Plan Type: Name: Misty Smith 1/1/2006 Contract Effective Date: 1-410-625-2200 Phone: For Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 1,164 [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: 21201 Zip: 4/16/2009Last Updated:







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


Contract Number: H5679 Legal Entity Name: HMO COLORADO, INC.










Legal Entity Name: MIDWEST HEALTH PLAN, INC.Organization Marketing Name: Midwest Advantage

Parent Organization: Midwest Health Plan, Inc.Local CCP Organization Type: DIRECTOR OF CUSTOMER SERVICES Contact Title: HMO/HMOPOS Plan Type: Name: Pat Vier 1/1/2006 Contract Effective Date: 1-313-586-6020 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: 1-313-586-6043 Fax:

Enrollment: 299 [email protected] Email: 5050 SCHAEFER ROAD Address:

5050 Schaefer Road Legal Entity Address: DEARBORNCity:

Dearborn City: MIState: MIState: 48126Zip: 48126 Zip: 3/26/2009Last Updated:

Contract Number: H5696 Legal Entity Name: PHYSICIANS UNITED PLAN, INC.

Organization Marketing Name: PUP Parent Organization: Physician's United Plan, Inc.

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/2006 Contract Effective Date: 1-866-571-0693 Phone: For Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-407-852-9066 Fax:

Enrollment: 17,709 [email protected] Email: 6220 S. Orange Blossom Trail Address:

483 North Semoran Boulevard Legal Entity Address: Orlando City:

Winter Park City: FLState: FLState: 32809Zip: 32792 Zip: 1/4/2008Last Updated:







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


Contract Number: H5698 Legal Entity Name: WINDSOR HEALTH PLANS, INC.

Organization Marketing Name: Windsor Medicare Extra Parent Organization: Windsor Health Group




Address: 7100 Commerce Way, Ste 285 Legal Entity Address: 7100 Commerce Way, Ste 285

City: Brentwood City: Brentwood State: TN




Legal Entity Name: ARKANSAS COMMUNITY CARE, INC.Organization Marketing Name: Arkansas Community Care, Inc.

Parent Organization: Arcadian Management Services Inc.Organization Type: Local CCP Contact Title:


Tax Status: For Profit Extension: CMS Region Responsible: Dallas Fax:

Enrollment: 7,639 Email: [email protected] Address: 825 Washington St. Suite 300

Legal Entity Address: 825 Washington St. Suite 300 City: Oakland

City: Oakland State: CA State: CA Zip: 94607

Zip: 94607 Last Updated: 2/28/2008 Contract Number: H5703 Legal Entity Name: SOUTH COUNTRY HEALTH ALLIANCE

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

Organization Type: Local CCP Contact Title: Marketing and Communications Manager Plan Type: HMO/HMOPOS Name: Ellen Lewis



Address: 110 West Fremont Street Legal Entity Address: 110 West Fremont Street

City: Owatonna City: Owatonna State: MN


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



Legal Entity Name: TRIPLE-S SALUD, INC.Organization Marketing Name: Triple-S Salud, INC.

Parent Organization: Triple-S Management Corporation


P. O. Box 363628

San Juan PR 009363628

For Profit New York



City: State:

Zip:


Enrollment: 1,452



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




PFFS Organization Type: Contact Title: PFFS Plan Type: Name: Aetna Customer Service 1/1/2006 Contract Effective Date: 1-800-445-1796 Phone: For Profit Tax Status: Extension: Boston CMS Region Responsible: Fax:




Contract Number: H5746 Legal Entity Name: AMERIGROUP NEW MEXICO, INC.

Organization Marketing Name: AMERIGROUP Community Care of New Mexico Parent Organization: AMERIGROUP Corporation

Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Dedicated Services UnitName: 1/1/2008 Contract Effective Date: 1-866-805-4589 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 910 [email protected] Email: AMERIGROUP Corporation Address:

2132-A #150 Central Avenue, SE Legal Entity Address: 4200 West Cypress Street, Suite 900 TampaCity:

Alburquerque City: FLState: NMState: 33607Zip: 87105 Zip: 6/15/2009Last 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: H5750 Legal Entity Name: METROPOLITAN HEALTH PLAN

Organization Marketing Name: North Star Advantage / North Star Advantage Plus Parent Organization: Metropolitan Health Plan


400 South Fourth Street Suite 201 Minneapolis MN 55415




City: State:

Zip:


Enrollment: 282


Government Programs Manager

1-612-596-9953

[email protected] 400 South 4th Street Suite 201 Minneapolis MN 55415 10/14/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Susan Sommers






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: H5760 Legal Entity Name: MCS ADVANTAGE, INC.

Organization Marketing Name: CosviMed Care Parent Organization: Cooperativa de Seguros de Vida de Puerto Rico




Address: MCS Plaza Legal Entity Address: PO BOX 363428 255 Ponce de Leon Avenue, Second Floor



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: 24,635 [email protected] Email: American Health Medicare Address:

Microsoft Building Metro Office Park Suite 3000 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


360 Campus Lane Suite 100 Fairfield CA 94534




City: State:

Zip:


Enrollment: 3,570


Data Entry and Enrollment Unit Coordinator

1-800-863-4155

1-707-863-4415 [email protected] 360 Campus Lane, Suite 100

Fairfield CA 94534 8/4/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Lisa Harrison


ARCADIAN HEALTH PLAN, INC. H5783




825 Washington Street, Suite 300

OAkland CA 94607

For Profit Dallas



City: State:

Zip:


Enrollment: 5,694


1-800-573-8597

[email protected] 825 Washington St. Suite 300

Oakland CA 94607 2/28/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:






151 Farmington Avenue

Hartford CT 06156

For Profit Boston



City: State:

Zip:


Enrollment: 2,250


1-800-445-1796


Hartford CT 06156 12/11/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


MOLINA HEALTHCARE OF CALIFORNIA H5810


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


200 Oceangate Suite 100

Long Beach CA 90802

For Profit Denver



City: State:

Zip:


Enrollment: 1,617


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 Parent Organization: Medcore HP


2609 E. Hammer Lane

Stockton CA 95210




City: State:

Zip:


Enrollment: 2,066


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




PFFS Organization Type: Director of Customer Service Contact Title: PFFS Plan Type: Renee BlasiName: 1/1/2006 Contract Effective Date: 1-800-498-9731 Phone: For Profit Tax Status: 16159Extension: Philadelphia CMS Region Responsible: 1-570-271-5970 Fax:


100 North Academy Avenue Legal Entity Address: DanvilleCity:

Danville City: PAState: PAState: 17822-3229 Zip: 178223220 Zip: 11/11/2007Last Updated:

Contract Number: H5813 Legal Entity Name: AETNA HEALTH, INC






Contract Number: H5817 Legal Entity Name: AMERIGROUP TEXAS, INC.



Enrollment: 5,595 [email protected] Email: AMERIGROUP Corporation Address:

1200 EAST COPELAND ROAD, SUITE 200, Legal Entity Address: 4200 West Cypress Street TampaCity:

ARLINGTON City: FLState: TXState: 33607Zip: 76011 Zip: 6/11/2009Last 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.

PFFS PFFS 1/1/2007

100 CENTRAL AVENUE SUITE 200 SAINT PETERSBURG FL 33701

For Profit Atlanta



City: State:

Zip:


Enrollment: 35,486


COMPLIANCE OFFICER

1-866-690-4842 6534 1-727-823-3840 [email protected] UNIVERSAL HEALTH CARE, INC. 100 CENTRAL AVENUE , SUITE 200 SAINT PETERSBURG FL 33701 12/22/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: BRUCE R HOFFMAN


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.

National PACE Organization Type: IT Coordinator Contact Title: National PACE Plan Type: Name: Dreux Doty 1/1/2007 Contract Effective Date: 1-785-232-2044 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Kansas CityCMS Region Responsible: Fax:

Enrollment: 55 [email protected] Email: 200 SW Frazier Circle Address:

200 SW Frazier Circle Legal Entity Address: TopekaCity:

Topeka City: KSState: KSState: 66606Zip: 66606 Zip: 10/25/2006Last Updated:

Contract Number: H5823 Legal Entity Name: MOLINA HEALTHCARE OF WASHINGTON, INC.

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




Address: 200 Oceangate Legal Entity Address: 21540 30th Dr. SE Ste. 100

Suite 400 City: Long Beach City: Bothell State: CA

State: WA Zip: 90802 Zip: 98021 Last Updated: 2/19/2008

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

Organization Type: Local CCP Contact Title: Director of Medicare Sales Plan Type: HMO/HMOPOS Name: Kris Pringle



Address: 720 Olive Way Legal Entity Address: 720 Olive Way Suite 300

Suite 300 City: Seattle City: Seattle State: WA









Contract Number: H5839 Legal Entity Name: STERLING LIFE INSURANCE COMPANY (MT)

Organization Marketing Name: Sterling Life Insurance Company Parent Organization: Munich American Holding Corporation

Organization Type: PFFS Contact Title: Customer Service Manager Plan Type: PFFS Name: Wendi Western



Address: 2219 Rimland Drive Legal Entity Address: 2219 Rimland Dr PO Box 5348

City: Bellingham City: Bellingham State: WA


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

PFFS PFFS 1/1/2007

601 Gaines Street

Little Rock AR 72201




City: State:

Zip:


Enrollment: 6,646


SUMMIT HEALTH PLAN, INC. H5850


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


1340 Concord Terrace

Sunrise FL 33323

For Profit Denver



City: State:

Zip:


Enrollment: 20,431


Manager Medicare Operations

1-501-378-6951

[email protected] 320 W. Capitol, Suite 400

Little Rock AR 72203 2/3/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Delena C Hicks

1-800-847-3995

1-954-858-3695 [email protected] 1340 Concord Terrace

Sunrise FL 33323 8/18/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Summit Customer Service


Contract Number: H5852 Legal Entity Name: AIDS HEALTHCARE FOUNDATION

Organization Marketing Name: POSITIVE HEALTHCARE PARTNERS Parent Organization: AIDS Healthcare Foundation

Local CCP Organization Type: Health Plan Adminstrator Contact Title: HMO/HMOPOS Plan Type: Michael O'Malley Name: 1/1/2006 Contract Effective Date: 1-800-263-0067 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-323-436-5034 Fax:

Enrollment: 662 [email protected] Email: 1001 N. Martel Ave. Address:

6255 WEST SUNSET BLVD 21ST FLOOR Legal Entity Address: LOS ANGELES City:

LOS ANGELES City: CAState: CAState: 90046Zip: 90028 Zip: 12/9/2008Last Updated:

Contract Number: H5854 Legal Entity Name: ANTHEM HEALTH PLANS, INC








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: 5,367 [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.


Organization Type:Plan Type:

Contract Effective Date:Tax Status:

CMS Region Responsible:Enrollment:


City:State:

Zip:

PFFS PFFS 1/1/2007 Not-for-Profit/Non-Profit Seattle 1,314

3000 E. Pine Avenue

Meridian ID 83642

Contact Title: Customer Service Manager, Medicare Advantage Plans Name: Sheri Core

Phone: 1-208-395-8205 Extension:

Fax: 1-208-387-6811 Email: [email protected]

Address: 3000 E. Pine Ave.

City: Meridian State: ID









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

Local CCP Organization Type: Manager, Provider Affairs Contact Title: HMO/HMOPOS Plan Type: Ashley Mabbitt Name: 1/1/2006 Contract Effective Date: 1-800-344-8525 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 30,264 [email protected] Email: 20500 Civic Center Dr. Address:

20500 Civic Center Drive Legal Entity Address: SouthfieldCity:

Southfield City: MIState: MIState: 48076Zip: 48076 Zip: 4/21/2009Last Updated:

Contract Number: H5884 Legal Entity Name: BLUECROSS BLUESHIELD OF TENNESSEE


Organization Type: PFFS Contact Title: Supervisor Medicare Advantage Operations Plan Type: PFFS Name: Carol Troxell



Address: 801 Pine Street Legal Entity Address: 801 Pine Street

City: Chattanooga City: Chattanooga State: TN


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

City: San Juan City: San Juan State: PR



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.


Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Dedicated Service UnitName: 1/1/2007 Contract Effective Date: 1-866-805-4589 Phone: For Profit Tax Status: Extension: New York CMS Region Responsible: Fax:

Enrollment: 2,378 [email protected] Email: 4200 West Cypress Street Address:

7550 Teague Road, Suite 500 Legal Entity Address: Suite 900 TampaCity:

Hanover City: FLState: MDState: 33607Zip: 21076 Zip: 6/11/2009Last Updated:

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


Organization Type: Demo Contact Title: Member Service Representative Plan Type: ESRD I - PFFS Name: Member Services



Address: 4888 Loop Central Drive Legal Entity Address: c/o HHS Texas Management Suite 900

4888 Loop Central Drive, Suite 800 City: Houston City: Houston State: TX







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: H5926 Legal Entity Name: MOLINA HEALTHCARE OF MICHIGAN

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


Enrollment: 2,071 [email protected] Email: 200 Oceangate Address:

100 W. Big Beaver Legal Entity Address: Ste. 100 Suite 600 Long Beach City: TroyCity: CAState: MIState: 90802Zip: 48084 Zip: 2/19/2008Last Updated:

Contract Number: H5928 Legal Entity Name: CARE1ST HEALTH PLAN

Organization Marketing Name: Care1st Medicare Advantage Plan Parent Organization: Care1st Health Plan

Organization Type: Local CCP Contact Title: Pharmacy Director Plan Type: HMO/HMOPOS Name: Michael Lasconia



Address: 601 Potrero Grande Drive Legal Entity Address: 601 Potrero Grande

City: Monterey Park City: Monterey Park State: CA


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

City: Pittsburgh City: Pittsburgh State: PA



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: 67 [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

Local CCP Organization Type: Network Services Supervisor Contact Title: HMO/HMOPOS Plan Type: Name: Beth Maige 1/1/2006 Contract Effective Date: 1-850-523-7307 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Atlanta CMS Region Responsible: 1-850-383-3413 Fax:


2140 CENTERVILLE PLACE Legal Entity Address: Tallahassee City:

TALLAHASSEE City: FLState: FLState: 32317Zip: 32308 Zip: 4/13/2009Last Updated:


Organization Marketing Name: VillageHealth Parent Organization: SCAN Health Plan, Inc.

Organization Type: Demo Contact Title: Member Services Plan Type: ESRD II - HMOPOS Name: Member Services


CMS Region Responsible: San Francisco Fax: Enrollment: 393 Email: [email protected]

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.


3333 Michelson Drive Suite 735 Irvine CA 92612




City: State:

Zip:


Enrollment: 649


Vice President Operations

1-949-260-6515

1-949-567-0211 [email protected] 3333 Michelson Drive Suite 735

Irvine CA 92612 9/9/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Karen Richmond







Hartford CT 06156

For Profit Boston



City: State:

Zip:


Enrollment: 101


1-800-445-1796


Hartford CT 06156 8/25/2006

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


CAMBRIDGE LIFE INSURANCE COMPANY H5952



PFFS PFFS 1/1/2007

6705 Rockledge Drive Suite 900

Bethesda MD 20817

For Profit Denver



City: State:

Zip:


Enrollment: 1,285


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: 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: 157



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

ALOHACARE H5969


Organization Marketing Name: AlohaCare Parent Organization: AlohaCare


1357 Kapiolani Blvd., Suite 1250

Honolulu HI 96814




City: State:

Zip:


Enrollment: 1,208


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:



Contract Number: H5978 Legal Entity Name: PHI LIFE

Organization Marketing Name: PHI LIFE dba everyday LIFE Parent Organization: PHI LIFE

Organization Type: National PACE Contact Title: Executive Director Plan Type: National PACE Name: Wendy Weaver


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

Address: 2045 Westgate Dr. Legal Entity Address: One Trinity Dr. East Suite 100

Suite 201 City: Bethlehem City: Dillsburg State: PA


Contract Number: H5980 Legal Entity Name: FIDELIS SECURECARE OF TEXAS, INC.

Organization Marketing Name: Fidelis SecureCare of Texas, Inc. 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: 17625 El Camino Real

Suite 210 City: Scranton City: Houston State: PA


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

Organization Type: Local CCP Contact Title: Plan Type: HMO/HMOPOS Name: Felice Liburd



Address: 2275 Olinville Avenue Legal Entity Address: 612 Allerton Avenue

City: Bronx City: Bronx State: NY



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: 1,829 [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

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



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

City: Cambridge City: Cambridge State: MA


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 PFFS 1/1/2007

21650 Oxnard St

Woodland Hills CA 91387

For Profit Seattle



City: State:

Zip:


Enrollment: 12,730


Provider and Provider Directory Information

1-800-977-8221

[email protected] 2019 Aerojet Rd., Mail Stop: CA-167-01-26

Rancho Cordova CA 95742-6418 3/14/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:





Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Medicare Member Services Name: 1/1/2007 Contract Effective Date: 1-800-290-4009 Phone: For Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 4,592 [email protected] Email: Unison Plaza Address:

890 Willow Tree Circle, Suite 10 Legal Entity Address: 1001 Brinton Road PittsburghCity:

Cordova City: PAState: TNState: 15221Zip: 38018 Zip: 4/17/2007Last Updated:


Organization Marketing Name: HISC - Blue Cross Blue Shield of IL, NM, OK & TX Parent Organization: Health Care Service Corporation

PFFS Organization Type: Contact Title: PFFS Plan Type: Brenda Hightower Name: 1/1/2008 Contract Effective Date: Phone: 1-972-766-1676 For Profit Tax Status: Extension: Dallas CMS Region Responsible: 1-972-766-0342 Fax:

Enrollment: * Email: [email protected] Blue Cross Blue Shield of Texas Address:

901 South Central Expressway, North BuildingLegal Entity Address: 901 S. Central Expressway Richardson City:

Richardson City: TXState: TXState: 75080Zip: 75080 Zip: 3/6/2007Last Updated:



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



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





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



Address: 393 E Walnut St Fl 7 Legal Entity Address: ONE KAISER PLAZA




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.

HCPP - 1833 Cost Organization Type: Business Manager / Controller Contact Title: HCPP - 1833 Cost Plan Type: Name: Myrna L Montana 1/1/1987 Contract Effective Date: 1-626-967-3550 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-626-967-3161 Fax:

Enrollment: 533 [email protected] Email: 551 e. San Bernardino Road, Address:

551 E. SAN BERNARDINO ROAD Legal Entity Address: CovinaCity:

COVINA City: CAState: CAState: 91723Zip: 91723 Zip: 7/7/2008Last Updated:

Contract Number: H6120 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF FLORIDA

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: 29 [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: 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: 1,783 [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)

Organization Type: HCPP - 1833 Cost Contact Title: No contact data submitted Plan Type: HCPP - 1833 Cost Name:

Contract Effective Date: 2/1/1983 Phone:Tax Status: Not-for-Profit/Non-Profit Extension:

CMS Region Responsible: Chicago Fax:Enrollment: 950 Email:

Address:Legal Entity Address: 333 SOUTH ASHLAND AVENUE

City:City: CHICAGO State:

State: IL Zip:Zip: 606072750 Last Updated:


UNION HEALTH SERVICES, INC. H6142


Organization Marketing Name: Union Health Service, Inc. Parent Organization: Union Health Services, Inc.

HCPP - 1833 Cost HCPP - 1833 Cost 2/1/1983

1634 WEST POLK STREET

CHICAGO IL 60612




City: State:

Zip:


Enrollment: 1,485


No contact data submitted Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name:

UNION MEDICAL CENTER H6143


Organization Marketing Name: Union Medical Center Parent Organization: Union Medical Center


1657 WEST ADAMS STREET

CHICAGO IL 60612




City: State:

Zip:


Enrollment: 777


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

Three Hawthorn Parkway Suite 410 Vernon Hills IL 60061

For Profit Denver



City: State:

Zip:


Enrollment: 98


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

CARESOURCE H6178


Organization Marketing Name: CareSource Parent Organization: CareSource


One Dayton Centre, 20th Floor One South Main Street Dayton OH 45402




City: State:

Zip:


Enrollment: 317


Director of Communications

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

Dayton OH 45401 3/4/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Michelle Chapman


Contract Number: H6181 Legal Entity Name: AMERIGROUP NEW YORK, LLC



Enrollment: 520 [email protected] Email: AMERIGROUP Corporation Address:

360 West 31st Street, Fifth Floor Legal Entity Address: 4200 Cypress Street, Suite 900 TampaCity:

New York City: FLState: NYState: 33607Zip: 10001 Zip: 6/11/2009Last Updated:

Contract Number: H6184 Legal Entity Name: COMPCARE HEALTH SERVICES INSURANCE CORPORATION












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.


7436 Bishop Ott Drive

Baton Rouge LA 70808




City: State:

Zip:


Enrollment: 45


Executive Director

1-225-490-0322

1-225-490-0354 [email protected] 7436 Bishop Ott Drive

Baton Rouge LA 70806 3/13/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Karen Allen


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: 275 [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

Organization Type: Local CCP Contact Title: Chief Operating Officer Plan Type: Local PPO Name: Brad Larson


CMS Region Responsible: Dallas Fax: 1-817-332-3614 Enrollment: 414 Email: [email protected]

Address: 1701 River Run Legal Entity Address: 1701 River Run Suite 402

Suite 402 City: Fort Worth City: Fort Worth State: TX


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: 1,690 [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


305 WEST 44TH STREET

NEW YORK NY 10036




City: State:

Zip:


Enrollment: 3,832


Compliance Officer, Government Programs

1-212-586-6400

[email protected] 305 West 44th Street

New York NY 11101 12/27/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Jordan Beasley


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.

1876 Cost Organization Type: Department Contact Title: 1876 Cost Plan Type: Name: Customer Relations 1/1/1987 Contract Effective Date: 1-216-749-8363 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-216-635-4453 Fax:

Enrollment: 19,895 [email protected] Email: 5500 Lancaster Drive Address:

North Point Tower, Suite 1200 Legal Entity Address: 1001 Lakeside Avenue Brooklyn HeightsCity: CLEVELAND City: OHState: OHState: 44131Zip: 441141153 Zip: 10/2/2008Last Updated:







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 PFFS 1/1/2007

8735 Henderson Rd Ren 2

Tampa FL 33634

For Profit Atlanta



City: State:

Zip:


Enrollment: 5,583



1-888-888-9355 3091


Tampa FL 33634 4/13/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Mary Solomon


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

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:


Contract Number: H6621 Legal Entity Name: THP INSURANCE COMPANY

Organization Marketing Name: Health Plan SecureFreedom Parent Organization: Health Plan of the Upper Ohio Valley

Organization Type: PFFS Contact Title: Director Member Services Plan Type: PFFS Name: Sherry Stanley



Address: The Health Plan Legal Entity Address: 52160 National Road East 52160 National Road East

City: St. Clairsville City: St. Clairsville State: OH








Mail Route MN-008 W140 City: Cyress City: Minnetonka State: CA



MVP HEALTH PLAN, INC. H6806



PFFS PFFS 1/1/2008

220 Alexander St.

Rochester NY 14607




City: State:

Zip:


Enrollment: 16,772


Sales Manager Medicare

1-800-999-3920


Rochester NY 14607 5/18/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


GUILDNET, INC. H6864


Organization Marketing Name: GuildNet Parent Organization: Guildnet, Inc.


15 WEST 65TH STREET

NEW YORK NY 10023




City: State:

Zip:


Enrollment: 150


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

HUMANA INSURANCE COMPANY H6900




1100 Employers Blvd.

DePere WI 54115




City: State:

Zip:


Enrollment: 986


1-800-457-4708



Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:


AETNA HEALTH H6923





Hartford CT 06156

For Profit Boston



City: State:

Zip:


Enrollment: 418


1-800-445-1796


Hartford CT 06156 1/24/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



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: 574 [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:

Contract Number: H6952 Legal Entity Name: GREAT LAKES HEALTH PLAN, INC.

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

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



Address: 17117 W. Nine Mile Rd. Ste 1600 Legal Entity Address: 17117 W. Nine Mile Road

Suite 1600 City: Southfield City: Southfield State: MI







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.


25 Broadway 9th Floor New York NY 10004




City: State:

Zip:


Enrollment: 2,969


Healthfirst Medicare Plan

1-888-801-1660

[email protected] 25 Broadway 9th Floor New York NY 10004 4/9/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last 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: Member Services Supervisor Contact Title: HMO/HMOPOS Plan Type: Name: Judith Fernandez 1/1/2008 Contract Effective Date: 1-619-498-6418 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-619-426-9437 Fax:

Enrollment: 621 [email protected] Email: 740 Bay Blvd.Address:

740 BAY BOULEVARD Legal Entity Address: Chula VistaCity:

CHULA VISTA City: CAState: CAState: 91910Zip: 91910 Zip: 6/12/2009Last Updated:

Contract Number: H7146 Legal Entity Name: MD CARE, INC.

Organization Marketing Name: San Miguel Health Plan Parent Organization: MD Care, Inc.

Organization Type: Local CCP Contact Title: Manager, Member Services Plan Type: HMO/HMOPOS Name: Angie Garcia



Address: 10941 Bloomfield Street Legal Entity Address: 100 West Broadway Suite F

Suite 4000 City: Los Alamitos City: Long Beach State: CA


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: 15950 West Dodge Road

City: Harrisburg City: Omaha State: PA

State: NE Zip: 17106 Zip: 681184030 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.




Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street, Suite 300








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







Contract Number: H7195 Legal Entity Name: NORTHLAND PACE PROGRAM

Organization Marketing Name: Northland PACE Program Parent Organization: Northland Healthcare Alliance

Organization Type: National PACE Contact Title: Plan Type: National PACE Name: Laurie Peters



Address: 201 North 24th Street Legal Entity Address: 201 North 24th Street

City: Bismarck City: Bismarck State: ND

State: ND Zip: 58501 Zip: 58501 Last Updated: 5/18/2009

Contract Number: H7200 Legal Entity Name: AMERIGROUP TENNESSEE, INC.





Address: AMERIGROUP Corporation Legal Entity Address: Three Lakeview Place 4200 West Cypress Street, Suite 900

22 Century Blvd., Suite 310 City: Tampa City: Nashville State: FL



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: 3,033 [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.

Local CCP Organization Type: Customer Solutions Center Manager Contact Title: HMO/HMOPOS Plan Type: Name: Trina Gibson 1/1/2009 Contract Effective Date: 1-317-963-9700 Phone: For Profit Tax Status: Extension: Chicago CMS Region Responsible: Fax:

Enrollment: 1,369 [email protected] Email: 1776 N. Meridian Street Address:

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

Indianapolis City: INState: INState: 46202Zip: 46202 Zip: 2/23/2009Last Updated:

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: 27,421 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




Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 FREDERICKBURG ROAD SUITE 360

City: San Antonio City: SAN ANTONIO State: TX



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.

Local CCP Organization Type: Director, Medicare/Individual Contact Title: Local PPO Plan Type: Name: Carol A Baker 1/1/2008 Contract Effective Date: 1-217-366-5708 Phone: For Profit Tax Status: Extension: Denver CMS Region Responsible: 1-217-366-5410 Fax:

Enrollment: 1,240 [email protected] Email: 2110 Fox DrAddress:

2110 Fox Drive, Ste. A Legal Entity Address: Champaign City:

Champaign City: ILState: ILState: 61820Zip: 61820 Zip: 3/5/2007Last Updated:

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.


2701 E. Elvira

Tucson AZ 85706




City: State:

Zip:


Enrollment: 1,300


Sales and Marketing Manager

1-520-874-5525

1-520-874-5555 [email protected] 2701 E. Elvira

Tucson AZ 85756 12/2/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: April Forman


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.


Enrollment: 79 [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: H7526 Legal Entity Name: MEDICA HEALTH PLAN





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

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


Three Hawthorn Parkway Suite 410 Vernon Hills IL 60061

For Profit Denver



City: State:

Zip:


Enrollment: 48


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


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.,




Address: 200 Oceangate Legal Entity Address: 2505 North Hwy 360, Suite 300 Ste. 100

City: Long Beach City: Grand Prairie State: CA


Contract Number: H7692 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY





Address: 3721 TecPort Dr Legal Entity Address: 6705 Rockledge Drive

Suite 900 City: Harrisburg City: Bethesda State: PA



Legal Entity Name: MD CARE, INC.Organization Marketing Name: MD Care Inc

Parent Organization: MD Care, Inc.Local CCP HMO/HMOPOS 1/1/2008

10941 Bloomfield Street Suite F Los Alamitos CA 90720




City: State:

Zip:


Enrollment: 6,180


Director, Administrative Services

1-888-285-9676

1-562-344-3321 [email protected] 1640 E Hill Street

Signal Hill CA 90755 5/12/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Gabriel ViolaName:


Contract Number: H7787 Legal Entity Name: HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.

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

Organization Type: Local CCP Contact Title: Vice President of Customer Service Plan Type: Local PPO Name: Wendy Wetzel



Address: 2900 North Loop West Suite 1300 Legal Entity Address: 2900 North Loop

West Suite 300 City: Houston City: Houston State: TX


Contract Number: H7908 Legal Entity Name: AETNA HEALTH








Contract Number: H7917 Legal Entity Name: BLUE CROSS BLUE SHIELD OF TENNESSEE



801 Pine Street

Chattanooga TN 37402




City: State:

Zip:


Enrollment: 5,366


PACIFICARE OF NEVADA, INC. H7949


Organization Marketing Name: Pacificare/UHC of Nevada Parent Organization: UnitedHealth Group, Inc.


9900 Bren Rd E

Minnetonka MN 55343




City: State:

Zip:


Enrollment: 1,148


Supervisor Medicare Advantage Operations

1-800-841-7434

[email protected] 801 Pine Street

Chattanooga TN 37402 2/22/2007

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Carol Troxell

1-888-867-5517


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Richard IrwinName:


Contract Number: H7981 Legal Entity Name: MCS LIFE INSURANCE COMPANY


Organization Type: PFFS Contact Title: VP A- Medicare Compliance Plan Type: PFFS Name: Carlos J Fournier


CMS Region Responsible: New York Fax: 1-787-620-6906 Enrollment: * Email: [email protected]

Address: MCS Plaza Legal Entity Address: 255 Ponce De Leon Ave, Suite 201 255 Ponce de Leon Avenue, Second Floor

City: San Juan City: San Juan State: PR


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

City: Pittsburgh City: Pittsburgh State: PA


Contract Number: H8096 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



Address: 407 Federal Street Legal Entity Address: 407 Federal Street

City: Lynchburg City: Lynchburg State: VA






For Profit Dallas



City: State:

Zip:


Enrollment: 847



1-866-422-5009


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:



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: Phone: 1-414-773-4000 For Profit Tax Status: Extension: Seattle CMS Region Responsible: Fax:

Enrollment: * Email: [email protected] 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: 15950 West Dodge Road

City: Harrisburg City: Omaha State: PA

State: NE Zip: 17106 Zip: 681184030 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.


4300 Hamilton Blvd

Sioux City IA 51104

Not-for-Profit/Non-Profit Kansas City



City: State:

Zip:


Enrollment: 33


Director

1-712-233-4105

1-712-233-1123 [email protected] 4300 Hamilton Blvd

Sioux City IA 51104 1/22/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Linda D Todd




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: 403 [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.

Organization Type: Local CCP Contact Title: Communications Manager Plan Type: HMO/HMOPOS Name: Joseph Kane



Address: Health New England, Inc. Legal Entity Address: One Monarch Place One Monarch Place, Suite 1500

Suite 1500 City: Springfield City: Springfield State: MA


Contract Number: H8604 Legal Entity Name: THP INSURANCE COMPANY

Organization Marketing Name: Health Plan SecureChoice Parent Organization: Health Plan of the Upper Ohio Valley

Organization Type: Local CCP Contact Title: Director Member Services Plan Type: Local PPO Name: Sherry Stanley



Address: The Health Plan Legal Entity Address: 52160 National Road East 52160 National Road East

City: St. Clairsville City: St. Clairsville State: OH











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: 4,956 [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.

National PACE Organization Type: Contact Title: National PACE Plan Type: Name: Courtney Bareford 2/1/2008 Contract Effective Date: 1-757-325-6084 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: Philadelphia CMS Region Responsible: Fax:

Enrollment: 145 [email protected] Email: 4107 W Mercury Blvd Address:

1020 Old Denbigh Blvd.Legal Entity Address: Hampton City:

Newport News City: VAState: VAState: 23666Zip: 23602 Zip: 6/10/2009Last Updated:







Contract Number: H8742 Legal Entity Name: ABRI HEALTH PLAN, INC

Organization Marketing Name: Universal American Parent Organization: ABRI Health Plan, Inc.


4888 Loop Central Drive Suite 800 Houston TX 77081

For Profit Dallas



City: State:

Zip:


Enrollment: 3,518


Member Service Representative

1-800-958-2710


Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:







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:







City: Maryland Heights City: Maryland Heights State: MO


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



Legal Entity Name: ELDERPLAN, INC.Organization Marketing Name: Elderplan, Inc.

Parent Organization: Elderplan, Inc.Local CCP Local PPO 1/1/2009

6323 Seventh Avenue

Brooklyn NY 11220




City: State:

Zip:


Enrollment: *


AVP Sales Admin., Informatics and Customer Service

1-718-759-4080

1-718-921-8824 [email protected] 6323 Seventh Avenue

Brooklyn NY 11220 2/20/2008

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Lois Faust


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: 206 [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

Organization Type: RFB - PFFS Contact Title: Customer Service Manager Plan Type: RFB PFFS Name: Wendi Western



Address: 2219 Rimland Drive Legal Entity Address: 1110 N. Main Street PO Box 5348

PO Box 483 City: Bellingham City: Goshen State: WA

State: IN Zip: 98227-5348 Zip: 46527 Last Updated: 1/14/2009



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.





Address: AMERIGROUP Corporation Legal Entity Address: 4200 W. Cypress Street, Suite 900 4200 West Cypress Street, Suite 900





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.





Address: 5757 Plaza Dr Legal Entity Address: 13621 N.W. 12TH ST. CA124-0142

City: Cyress City: SUNRISE State: CA



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.,




Address: 200 Oceangate Legal Entity Address: 8801 Horizons Blvd., Suite 400 Ste. 100

City: Long Beach City: Albuquerque State: CA

State: NM Zip: 90802 Zip: 87113 Last Updated: 2/19/2008

Contract Number: H9101 Legal Entity Name: ELDERPLAN, INC. - SHMO

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

Organization Type: Local CCP Contact Title: AVP Sales Admin., Informatics and Customer Service Plan Type: HMO/HMOPOS Name: Lois Faust



Address: 6323 Seventh Avenue Legal Entity Address: 6323 SEVENTH AVENUE

City: Brooklyn City: BROOKLYN State: NY


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.




Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Airport Way Suite 100





Local CCP Organization Type: Contact Title: HMO/HMOPOS Plan Type: Richard IrwinName: 1/1/2009 Contract Effective Date: Phone: 1-888-867-5517 For Profit Tax Status: Extension: San Francisco CMS Region Responsible: 1-714-226-6811 Fax:

Enrollment: * Email: [email protected] 5757 Plaza Dr 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: 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: 24 [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.


7502 Lakewood Dr. W, Suite A Lakewood WA 98499

For Profit Seattle



City: State:

Zip:


Enrollment: 4,457



1-253-779-8830

1-253-779-8829 [email protected] 400 Mercer St Suite 410 Seattle WA 98109 5/19/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Christine K Turner


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.

Local CCP Organization Type: Member ServicesContact Title: HMO/HMOPOS Plan Type: Name: Member Services 1/1/2007 Contract Effective Date: 1-800-559-3500 Phone: Not-for-Profit/Non-Profit Tax Status: Extension: San Francisco CMS Region Responsible: Fax:

Enrollment: 1,446 [email protected] Email: 3800 Kilroy Airport Way Address:

3800 Kilroy Airport Way Suite 100Legal Entity Address: Suite 100 Long Beach City:

Long Beach City: CAState: CAState: 90806Zip: 90806 Zip: 7/2/2009Last Updated:

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


Contract Number: H9615 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



Address: 220 Alexander St Legal Entity Address: 625 State Street

City: Rochester City: Schenectady State: NY











Contract Number: H9670 Legal Entity Name: UPMC HEALTH BENEFITS, INC.


Local CCP Organization Type: Medicare Hotline Contact Title: Local PPO 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: * [email protected] Email: 112 Washington PlaceAddress:

112 Washington Place Legal Entity Address: PittsburghCity:


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

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: 2,587 [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: 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:


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: Phone: 1-866-731-9574 For Profit Tax Status: Extension: Denver CMS Region Responsible: Fax:

Enrollment: 2,746 Email: [email protected] Address: 3721 TecPort Drive

6705 Rockledge Drive Legal Entity Address: Suite 900 City: Harrisburg Bethesda City: State: PA MDState: Zip: 17111 20817 Zip: Last Updated: 4/14/2009



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 Contract Effective Date: 1/1/2007 Phone: 1-888-280-6205

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

Enrollment: 6,650 Email: [email protected] Address: 220 Alexander St

Legal Entity Address: 625 State Street City: Rochester

City: Schenectady State: NY State: NY Zip: 14607

Zip: 12305 Last Updated: 5/18/2009 Contract Number: H9882 Legal Entity Name: VIRGINIA PREMIER HEALTH PLAN, INC.

Organization Marketing Name: Virginia Premier Gold Parent Organization: Virginia Premier Health Plan, Inc.

Local CCP Organization Type: Director, Medicare Programs Contact Title: HMO/HMOPOS Plan Type: Name: Jill Sumner 1/1/2008 Contract Effective Date: 1-804-819-5151 Phone: For Profit Tax Status: 5451Extension: Philadelphia CMS Region Responsible: 1-804-819-5187 Fax:

Enrollment: 302 [email protected] Email: 600 E Broad St Address:

600 EAST BROAD STREET Legal Entity Address: SUITE 400 RichmondCity: RICHMOND City: VAState: VAState: 23220Zip: 23220 Zip: 6/13/2008Last Updated:









Contract Number: H9931 Legal Entity Name: HEALTHPARTNERS INSURANCE COMPANY

Organization Marketing Name: HealthPartners Liberty Medicare Parent Organization: HealthPartners, Inc.

Organization Type: PFFS Contact Title: Plan Type: PFFS Name: Provider Services



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

City: Minneapolis City: Bloomington State: MN



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


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: R3444 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.


Organization Type: Regional CCP Contact Title: Marketing Manager Plan Type: Regional PPO Name: Misty Smith



Address: 351 West Camden Street Legal Entity Address: 351 West Camden Street Suite 100

Suite 100 City: Baltimore City: Baltimore State: MD




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







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 Regional PPO 1/1/2006

2720 N. Tenaya Way

Las Vegas NV 89128




City: State:

Zip:


Enrollment: 3,612



1-702-838-2066


Las Vegas NV 89128 6/9/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last 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.

Organization Type: Regional CCP Contact Title: Provider and Provider Directory Information Plan Type: Regional PPO Name: Member Services



Address: P.O. Box 881 Legal Entity Address: 1230 West Washington St.

Suite 401 City: Shelton City: Tempe State: CT


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 Regional PPO 1/1/2007

351 West Camden Street Suite 100 Baltimore MD 21201




City: State:

Zip:


Enrollment: 14,582


Marketing Manager

1-410-625-2200 8701

[email protected] 351 West Camden Street Suite 100 Baltimore MD 21201 2/25/2009

Contact Title:

Phone: Extension:

Fax: Email:

Address:

City: State:

Zip: Last Updated:

Name: Misty Smith






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 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: 30,141 [email protected] Email: 351 West Camden Street Address:


Contract Number: R9943 Legal Entity Name: ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO.


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







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