Agency Code 12000 Contract No. C-017720 Period 4/1/05 – 9/30/05 Funding Amount for Period Based on approved capitation rates

APPENDIX X

This is an AGREEMENT between THE STATE OF NEW YORK, acting by and through
The New York State Department of Health, having its principal office at Corning Tower, Room ▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇, (hereinafter referred to as the STATE), and WellCare of New
York, Inc., (hereinafter referred to as the CONTRACTOR), to modify Contract Number C017720 by substituting the attached Appendix L Approved Capitation Payment Rates for the FHPlus Program. The effective date of these modifications is April 1, 2005.

All other provisions of said AGREEMENT shall remain in full force and effect.

IN WITNESS WHEREOF, the parties hereto have executed this AGREEMENT as of the dates appearing under their signatures.

     ▇▇▇▇ ▇. ▇▇▇▇▇     ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇      

Printed Name Printed Name

Title: _President and CEO     Title:      Deputy Director, OMC     

In addition to the acceptance of this contract, I also certify that original copies of this signature page will be attached to all other exact copies of this contract.

On the _1^st      day of      July       20     05     , before me personally appeared      ▇▇▇▇ ▇. ▇▇▇▇▇     , to me known, who being by me duly sworn, did depose
and say that he resides at      Tampa, Florida      ,
that he is the _President and CEO     of _WellCare of New York, Inc.     , the corporation described herein which executed the foregoing instrument; and that he signed his
name thereto by order of the board of directors of said corporation.

(Notary) ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇

1

Appendix L

Family Health Plus

Approved Capitation Payment Rates

for the FHPlus Program

FHPlus
Appendix X
April 1, 2005WELLCARE OF NEW YORK, INC.

Family Health Plus Rates
Effective April 1, 2005
Optional
benefits covered

2