Plan Directory for Medicare Advantage, Cost, PACE, and Demonstration Organizations. Sorted by Legal Entity Name
|
|
|
- Dina Francis
- 10 years ago
- Views:
Transcription
1 Plan Directory for Medicare Advantage, Cost, PACE, and Demonstration Organizations Sorted by Legal Entity Name CPC/MDBG/DPD June 2009
2 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: 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 Pilot contracts are excluded from this directory.
3 Legal Entity Name: ABRAZO ADVANTAGE HEALTH PLAN Contract Number: H5985 Organization Marketing Name: Abrazo Advantage Health Plan Parent Organization: Vanguard Health Systems Director of Marketing Name: Myrna Chaydez Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 2,828 Address: 7878 N. 16th St. Legal Entity Address: 7878 N. 16th St. Suite 105 Suite 105 City: Phoenix City: Phoenix State: AZ State: AZ Zip: Zip: Last Updated: 11/6/2008 Legal Entity Name: ABRI HEALTH PLAN, INC Contract Number: H8742 Organization Marketing Name: Universal American Parent Organization: ABRI Health Plan, Inc. Member Service Representative Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 3,500 Address: 4888 Loop Central Drive Legal Entity Address: 4888 Loop Central Drive Suite 900 Suite 800 City: Houston City: Houston State: TX State: TX Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: ADVANTAGE HEALTH SOLUTIONS, INC. Contract Number: H5508 Organization Marketing Name: Advantage Health Solutions, Inc. Parent Organization: Advantage Health Solutions Manager of Marketing and Enrollment Strategies Name: Cynthia Stepp Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 2,499 Address: 9045 River Road, Suite 200 Legal Entity Address: 9045 River Road, Suite 200 City: Indianapolis City: Indianapolis State: IN State: IN Zip: Zip: Last Updated: 10/23/2008 Legal Entity Name: ADVANTAGE HEALTH SOLUTIONS, INC. Contract Number: H8822 Organization Marketing Name: ADVANTAGE Health Solutions, Inc. Parent Organization: Advantage Health Solutions Manager of Marketing and Enrollment Strategies Name: Cynthia Stepp Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Chicago Enrollment: Address: 9045 River Road, Suite 200 Legal Entity Address: 9045 River Road, Suite 200 City: Indianapolis City: Indianapolis State: IN State: IN Zip: Zip: Last Updated: 7/21/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 3 of 190
4 Legal Entity Name: AETNA HEALTH Contract Number: H3597 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: 1,495 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA HEALTH Contract Number: H6923 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: AETNA HEALTH Contract Number: H7908 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA HEALTH INC Contract Number: H3931 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 11/1/1985 Phone: CMS Region Responsible: Boston Enrollment: 41,578 Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 8/23/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 4 of 190
5 Legal Entity Name: AETNA HEALTH INC. Contract Number: H0318 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 1,274 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue Mail Stop RT 11 City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: AETNA HEALTH INC. Contract Number: H0901 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 1302 Concourse Drive, Suite 402 City: Hartford City: Linthicum State: CT State: MD Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: AETNA HEALTH INC. Contract Number: H3312 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 10/1/1986 Phone: CMS Region Responsible: Boston Enrollment: 15,257 Address: 151 Farmington Avenue Legal Entity Address: 99 PARK AVENUE City: Hartford City: NEW YORK State: CT State: NY Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA HEALTH INC. Contract Number: H4523 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 4,627 Address: 151 Farmington Avenue Legal Entity Address: 2777 Stemmons Freeway Suite 400 City: Hartford City: Dallas State: CT State: TX Zip: Zip: Last Updated: 8/23/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 5 of 190
6 Legal Entity Name: AETNA HEALTH INC. Contract Number: H4910 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 1302 Concourse Drive City: Hartford City: Linthicum State: CT State: MD Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA HEALTH INC. Contract Number: H5414 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 2,687 Address: 151 Farmington Avenue Legal Entity Address: 4630 Woodlands Corporate Blvd. City: Hartford City: Tampa State: CT State: FL Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: AETNA HEALTH INC. Contract Number: H5793 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Boston Enrollment: 2,160 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA HEALTH INC. Contract Number: H5832 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/25/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 6 of 190
7 Legal Entity Name: AETNA HEALTH INC. Contract Number: H5950 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Boston Enrollment: 96 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/25/2006 Legal Entity Name: AETNA HEALTH INC. (MARYLAND) Contract Number: H2112 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 2/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 5,777 Address: 151 Farmington Avenue Legal Entity Address: 1302 Concourse Drive, Suite 402 City: Hartford City: Linthicum State: CT State: MD Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA HEALTH INC.(GEORGIA) Contract Number: H1109 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 1,493 Address: 151 Farmington Avenue Legal Entity Address: Great Oaks Way City: Hartford City: Alpharetta State: CT State: GA Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA HEALTH OF CALIFORNIA,INC. Contract Number: H0523 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 5/1/1986 Phone: CMS Region Responsible: Boston Enrollment: 28,033 Address: 151 Farmington Avenue Legal Entity Address: 2409 CAMINO RAMON City: Hartford City: SAN RAMON State: CT Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 7 of 190
8 Legal Entity Name: AETNA HEALTH OF ILLINOIS, INC. Contract Number: H1419 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 1,082 Address: 151 Farmington Avenue Legal Entity Address: 100 N. Riverside Plaza, 20th Floor City: Hartford City: Chicago State: CT State: IL Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA HEALTH, INC. Contract Number: H3623 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 2,923 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Ave City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA HEALTH, INC Contract Number: H5813 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/25/2006 Legal Entity Name: AETNA HEALTH, INC. Contract Number: H3152 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 9/1/1993 Phone: CMS Region Responsible: Boston Enrollment: 36,624 Address: 151 Farmington Avenue Legal Entity Address: 55 LANE ROAD City: Hartford City: FAIRFIELD State: CT State: NJ Zip: Zip: Last Updated: 12/11/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 8 of 190
9 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H0322 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 FARMINGTON AVE City: Hartford City: HARTFORD State: CT State: CT Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H0768 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H0902 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 42 Address: 151 Farmington Avenue Legal Entity Address: 151 FARMINGTON AVENUE City: Hartford City: HARTFORD State: CT State: CT Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H1110 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/23/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 9 of 190
10 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H1420 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H2047 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: PA Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H3624 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 HARTFORD AVENUE City: Hartford City: HARTFORD State: CT State: CT Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H4362 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 12/11/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 10 of 190
11 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H4524 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 2,273 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H4781 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: 90 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H4911 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 FARMINGTON AVENUE City: Hartford City: HARTFORD State: CT State: CT Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5144 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 1/24/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 11 of 190
12 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5437 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: 151 Farmington Avenue Legal Entity Address: 151 FARMINGTON AVENUE City: Hartford City: HARTFORD State: CT State: CT Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5510 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Boston Enrollment: 3,716 Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5512 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Boston Enrollment: 8,045 Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5521 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Boston Enrollment: 12,642 Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 8/24/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 12 of 190
13 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5531 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Boston Enrollment: 1,393 Address: 151 Farmington Avenue Legal Entity Address: 980 Jolly Road City: Hartford City: Blue Bell State: CT State: PA Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H5736 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Organization Type: PFFS Plan Type: PFFS Name: Aetna Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Boston Enrollment: 239,451 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: H9663 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Name: Aetna Customer Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: 78 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Avenue City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: AETNA LIFE INSURANCE COMPANY Contract Number: R5595 Organization Marketing Name: Aetna Medicare Parent Organization: Aetna Inc. Organization Type: Regional CCP Plan Type: Regional PPO Name: Aetna Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Boston Enrollment: 1,673 Address: 151 Farmington Avenue Legal Entity Address: 151 Farmington Ave City: Hartford City: Hartford State: CT State: CT Zip: Zip: Last Updated: 8/25/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 13 of 190
14 Legal Entity Name: AFFINITY HEALTH PLAN, INC. Contract Number: H5991 Organization Marketing Name: Affinity Health Plan Parent Organization: Affinity Health Plan Director of Customer Service Name: Evelyn Rodriguez Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 1,739 Address: 2500 Halsey Street Legal Entity Address: 2500 Halsey Street City: Bronx City: Bronx State: NY State: NY Zip: Zip: Last Updated: 12/14/2007 Legal Entity Name: AIDS HEALTHCARE FOUNDATION Contract Number: H5852 Organization Marketing Name: POSITIVE HEALTHCARE PARTNERS Parent Organization: AIDS Healthcare Foundation 1/1/2006 Health Plan Adminstrator Name: Michael O'Malley Phone: Contract Effective Date: CMS Region Responsible: San Francisco Enrollment: Address: 1001 N. Martel Ave. Legal Entity Address: 6255 WEST SUNSET BLVD 21ST FLOOR City: LOS ANGELES City: LOS ANGELES Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: AIDS HEALTHCARE FOUNDATION MCO OF FLORIDA, INC. Contract Number: H3132 Organization Marketing Name: Positive Healthcare Partners Parent Organization: AIDS Healthcare Foundation Health Plan Adminstrator Name: Michael O'Malley Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 1001 N. Martel Ave. Legal Entity Address: 110 SE 6th St., Ste City: LOS ANGELES City: Fort Lauderdale State: FL Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: ALAMEDA ALLIANCE JOINT POWERS AUTHORITY (JPA) Contract Number: H7292 Organization Marketing Name: Alliance for Health Parent Organization: Alameda Alliance for Health Organization Type:Local CCP Plan Type:HMO/HMOPOS Contract Effective Date:1/1/2008 Tax Status:Not-for-Profit/Non-Profit CMS Region Responsible:San Francisco Enrollment:1,113 Medicare Compliance Coordinator Name: Suzanne Tsang Phone: Address: 1240 South Loop Road Legal Entity Address: 1240 South Loop Road City: Alameda City:Alameda State:CA Zip: Zip:94502 Last Updated: 1/22/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 14 of 190
15 Legal Entity Name: ALEXIAN BROTHERS COMMUNITY SERVICES Contract Number: H2609 Organization Marketing Name: Alexian Brothers Community Services Parent Organization: Alexian Brothers Community Services Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 11/1/2001 CMS Region Responsible: Kansas City Enrollment: 157 Legal Entity Address: 3900 SOUTH GRAND BOULEVARD City: ST. LOUIS State: MO Zip: Legal Entity Name: ALEXIAN BROTHERS COMMUNITY SERVICES Contract Number: H4402 Organization Marketing Name: Alexian Brothers Community Services Parent Organization: Alexian Brothers Community Services Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 11/1/2002 CMS Region Responsible: Atlanta Enrollment: 301 Legal Entity Address: 425 CUMBERLAND STREET Suite 110 City: CHATTANOOGA State: TN Zip: Legal Entity Name: ALLIANCE HEALTH AND LIFE INSURANCE, CO Contract Number: H2322 Organization Marketing Name: Alliance Medicare PPO Parent Organization: Health Alliance Plan (HAP) Contract Effective Date: 8/1/2005 CMS Region Responsible: Chicago Enrollment: 3,269 Legal Entity Address: 2850 WEST GRAND BLVD. City: Detroit State: MI Zip: Legal Entity Name: ALOHACARE Contract Number: H5969 Organization Marketing Name: AlohaCare Parent Organization: AlohaCare Contract Effective Date: 1/1/2006 CMS Region Responsible: San Francisco Enrollment: 1,204 Legal Entity Address: 1357 Kapiolani Blvd., Suite 1250 City: Honolulu State: HI Zip: Marketing Director Name: Rebecca Boerner Phone: Address: 3900 S. Grand City: St. Louis State: MO Zip: Last Updated: 6/14/2007 IT Name: Jon Gabert Phone: Address: 425 Cumberland Street Suite 110 City: Chattanooga State: TN Zip: Last Updated: 4/1/2008 Coach/Manager Tech Planning Name: Cindy Hoffman Phone: Address: 2850 W. Grand Blvd. City: Detroit State: MI Zip: Last Updated: 8/17/2006 Customer Service Public Web Site Contact Phone: Address: 1357 Kapiolani Blvd., Suite 1250 City: Honolulu State: HI Zip: Last Updated: 11/20/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 15 of 190
16 Legal Entity Name: ALTAMED HEALTH SERVICES CORPORATION Contract Number: H0542 Organization Marketing Name: AltaMed Senior BuenaCare Parent Organization: Altamed Health Services Corporation Organization Type: National PACE Plan Type: National PACE SBC PACE Center Manager Name: Jhones T Vergara Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 5425 E Pomona Blvd Legal Entity Address: 500 CITADEL DRIVE SUITE 490 City: Los Angeles City: LOS ANGELES Zip: Zip: Last Updated: 6/20/2008 Legal Entity Name: ALTIUS HEALTH PLANS, INC. (UTAH) Contract Number: H8649 Organization Marketing Name: Altius Advantra Parent Organization: Coventry Health Care Inc. 1/1/2008 Director, Medicare Product Name: Jamie Moser Phone: Contract Effective Date: CMS Region Responsible: Denver Enrollment: 4,796 [email protected] Address: South Jordan Gateway Legal Entity Address: South Jordan Gateway Suite 400 Suite 400 City: South Jordan City: South Jordan State: UT State: UT Zip: Zip: Last Updated: 12/24/2007 Legal Entity Name: ALTIUS HEALTH PLANS, INC. (WYOMING) Contract Number: H0806 Organization Marketing Name: Altius Advantra Parent Organization: Coventry Health Care Inc. Director, Medicare Product Name: Jamie Moser Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 62 [email protected] Address: South Jordan Gateway Legal Entity Address: South Jordan Gateway Suite 400 Suite 400 City: South Jordan City: South Jordan State: UT State: UT Zip: Zip: Last Updated: 12/24/2007 Legal Entity Name: AMARILLO MULTISVC CTR FR THE AGING INC Contract Number: H4517 Organization Marketing Name: Amarillo Multisvc Ctr For The Aging Inc Parent Organization: Amarillo Multisvc Ctr Fr the Aging Inc Organization Type: National PACE Plan Type: National PACE Name: Alana Chilcote Contract Effective Date: 3/1/2004 Phone: CMS Region Responsible: Dallas Enrollment: [email protected] Address: 3108 S Fillmore Legal Entity Address: 3108 SOUTH FILLMORE STREET City: Amarillo City: AMARILLO State: TX State: TX Zip: Zip: Last Updated: 5/20/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 16 of 190
17 Legal Entity Name: AMERICAN HEALTH, INC. Contract Number: H5774 Organization Marketing Name: American Health Medicare Parent Organization: American Health Plan Chief Sales and Marketing Officer Name: Kevin Grace Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 24,252 Address: American Health Medicare Legal Entity Address: Microsoft Building Metro Office Park Suite 300 Lot 18 P.O. Box City: San Juan City: Guaynabo State: PR State: PR Zip: Zip: Last Updated: 11/11/2008 Legal Entity Name: AMERICAN PROGRESSIVE LIFE & HEALTH INSURANCE OF NY Contract Number: H1317 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: 23 Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: AMERICAN PROGRESSIVE LIFE & HEALTH INSURANCE OF NY Contract Number: H2775 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: AMERICAN PROGRESSIVE LIFE & HEALTH INSURANCE OF NY Contract Number: H2869 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: 18 Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 17 of 190
18 Legal Entity Name: AMERICAN PROGRESSIVE LIFE AND HEALTH OF NEW YORK Contract Number: H5909 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Organization Type: Demo Plan Type: ESRD I - PFFS Member Service Representative Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Dallas Enrollment: 90 [email protected] Address: 4888 Loop Central Drive Legal Entity Address: c/o HHS Texas Management Suite Loop Central Drive, Suite 800 City: Houston City: Houston State: TX State: TX Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: AMERICAN PROGRESSIVE LIFE/HLTH INS. Contract Number: H3333 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Organization Type: PFFS Member Services Representative Plan Type: PFFS Name: Member Services Contract Effective Date: 5/1/2004 Phone: CMS Region Responsible: Dallas Enrollment: 51,512 [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 State: FL Zip: Zip: Last Updated: 10/18/2007 Legal Entity Name: AMERICA'S 1ST CHOICE HEALTH PLANS, INC. Contract Number: H9720 Organization Marketing Name: AMERICA'S 1ST CHOICE HEALTH PLANS, INC. Parent Organization: Dr. Kiran C. Patel Organization Type: PFFS Plan Type: PFFS Name: Robin Florez Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 2,565 [email protected] Address: 5403 N. Church Ave. Legal Entity Address: 140 Stoneridge Drive Suite 480 City: Tampa City: Columbia State: FL State: SC Zip: Zip: Last Updated: 10/31/2008 Legal Entity Name: AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. Contract Number: H0979 Organization Marketing Name: AMERICA'S 1ST CHOICE INSURANCE COMPANY OF NC, INC. Parent Organization: Dr. Kiran C. Patel Organization Type:PFFS Plan Type:PFFS Name: Robin Florez Contract Effective Date:1/1/2008 Phone: Tax Status:For Profit CMS Region Responsible:Atlanta Enrollment:3,231 [email protected] Address: 5403 N. Church Ave. Legal Entity Address: 140 Stoneridge Drive Suite 480 City: Tampa City:Columbia State: FL State:SC Zip: Zip:29201 Last Updated: 10/31/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 18 of 190
19 Legal Entity Name: AMERICHOICE OF NEW JERSEY, INC Contract Number: H3164 Organization Marketing Name: AmeriChoice Personal Care Plus Name: Diana Torres-Soto Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: San Francisco Enrollment: 2,635 Address: Four Gateway Center, 4th floor Legal Entity Address: Four Gateway Center 100 Mulberry Street 4th Floor City: Newark City: Newark State: NJ State: NJ Zip: Zip: Last Updated: 3/12/2009 Legal Entity Name: AMERIGROUP FLORIDA, INC. Contract Number: H8991 Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation 1/1/2008 CMS Region Responsible: New York Enrollment: 1,463 Name: Dedicated Services Unit Contract Effective Date: Phone: Legal Entity Address: 4200 W. Cypress Street, Suite 900 City: Tampa State: FL Address: AMERIGROUP Corporation 4425 Corporation Lane City: Virginia Beach State: VA Zip: Last Updated: Zip: /3/2009 Legal Entity Name: AMERIGROUP MARYLAND, INC. Contract Number: H5896 Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation Name: Dedicated Services Unit Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 2,301 Address: AMERIGROUP Corporation Legal Entity Address: 7550 Teague Road, Suite Corporation Lane City: Virginia Beach City: Hanover State: VA State: MD Zip: Zip: Last Updated: 2/3/2009 Legal Entity Name: AMERIGROUP NEW JERSEY, INC. Contract Number: H3240 Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation Name: Dedicated Services Unit Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 1,151 Address: AMERIGROUP Corporation Legal Entity Address: 399 Thornall Street 4425 Corporation Lane Ninth Floor City: Virginia Beach City: Edison State: VA State: NJ Zip: Zip: Last Updated: 12/11/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 19 of 190
20 Legal Entity Name: AMERIGROUP NEW MEXICO, INC. Contract Number: H5746 Organization Marketing Name: AMERIGROUP Community Care of New Mexico Parent Organization: AMERIGROUP Corporation Name: Dedicated Services Unit Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: Address: AMERIGROUP Corporation Legal Entity Address: 2132-A #150 Central Avenue, SE City: Alburquerque State: NM Corporation Lane City: Virginia Beach State: VA Zip: Zip: Last Updated: 11/3/2007 Legal Entity Name: AMERIGROUP NEW YORK, LLC Contract Number: H6181 Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation 1/1/2008 CMS Region Responsible: New York Enrollment: 507 Name: Dedicated Services Unit Contract Effective Date: Phone: Legal Entity Address: 360 West 31st Street, Fifth Floor City: New York State: NY Address: AMERIGROUP Corporation 4425 Corporation Lane City: Virginia Beach State: VA Zip: Last Updated: Zip: /3/2009 Legal Entity Name: AMERIGROUP TENNESSEE, INC. Contract Number: H7200 Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation Name: Dedicated Services Unit Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: Address: AMERIGROUP Corporation Legal Entity Address: Three Lakeview Place 4425 Corporation Lane 22 Century Blvd., Suite 310 City: Virginia Beach City: Nashville State: VA State: TN Zip: Zip: Last Updated: 2/3/2009 Legal Entity Name: AMERIGROUP TEXAS, INC. Contract Number: H5817 Organization Marketing Name: AMERIGROUP Community Care Parent Organization: AMERIGROUP Corporation Name: Dedicated Services Unit Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 5,546 Address: AMERIGROUP Corporation Legal Entity Address: 1200 EAST COPELAND ROAD, SUITE 200, 4425 Corporation Lane City: Virginia Beach City: ARLINGTON State: VA State: TX Zip: Zip: Last Updated: 2/3/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 20 of 190
21 Legal Entity Name: AMERIHEALTH HMO_INC Contract Number: H3156 Organization Marketing Name: AmeriHealth 65 Parent Organization: Independence Blue Cross Name: Plan Inquiries Contract Effective Date: 10/1/1995 Phone: CMS Region Responsible: Philadelphia Enrollment: 2,080 Address: 1901 Market Street Legal Entity Address: 1901 MARKET STRRET 45 TH FLOOR City: Phila. City: PHILADELPHIA State: PA State: PA Zip: Zip: Last Updated: 9/6/2007 Legal Entity Name: ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. Contract Number: R9943 Organization Marketing Name: Anthem Blue Cross Parent Organization: Wellpoint, Inc. Organization Type: Regional CCP Plan Type: Regional PPO Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 36,687 Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Thousand Oaks CA City: Oxnard Zip: Last Updated: State: Zip: 4/25/2008 Legal Entity Name: ANTHEM HEALTH PLANS OF KENTUCKY, INC. Contract Number: H1849 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/1998 Phone: CMS Region Responsible: Chicago Enrollment: 7,442 [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM HEALTH PLANS OF KENTUCKY, INC. Contract Number: H5530 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 2,741 [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 21 of 190
22 Legal Entity Name: ANTHEM HEALTH PLANS OF VIRGINIA, INC. Contract Number: H4909 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 1,429 Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM HEALTH PLANS, INC Contract Number: H5854 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: 2,237 [email protected] Address: P.O. Box 1407 Legal Entity Address: 1 WellPoint Way Church Street Station CAT201-C004 City: New York City: Thousand Oaks State: NY Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC. Contract Number: H1511 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC. Contract Number: H1517 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 22 of 190
23 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC. Contract Number: H1607 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 3,343 Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC. Contract Number: H1689 Organization Marketing Name: Anthem Insurance Companies, Inc. Parent Organization: Wellpoint, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: 39,800 [email protected] Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC. Contract Number: H4036 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ANTHEM INSURANCE COMPANIES, INC. Contract Number: R5941 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Organization Type: Regional CCP Plan Type: Regional PPO Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 26,612 [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 23 of 190
24 Legal Entity Name: APPALACHIAN AENCY FOR SENIOR CITIZENS, INC. Contract Number: H2386 Organization Marketing Name: Appalachian Agency for Senior Citizens, Inc, Parent Organization: Appalachian Agency for Senior Citizens, Inc. Organization Type: National PACE Plan Type: National PACE Deputy Director Name: Patrick DeMesa Contract Effective Date: 5/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: 27 Address: P.O.B. 765 Legal Entity Address: P.O.B. 765 City: Cedar Bluff City: Cedar Bluff State: VA State: VA Zip: Zip: Last Updated: 5/5/2009 Legal Entity Name: ARCADIAN HEALTH PLAN Contract Number: H4125 Organization Marketing Name: Arcadian Health Plan Parent Organization: Arcadian Management Services Inc. Name: Member Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street., Suite 300 City: Oakland City: Oakland Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARCADIAN HEALTH PLAN OF GEORGIA, INC. Contract Number: H5578 Organization Marketing Name: Southeast Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 2,417 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 WASHINGTON STREET, SUITE 300 City: Oakland City: OAKLAND Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARCADIAN HEALTH PLAN OF LOUISIANA, INC. Contract Number: H7179 Organization Marketing Name: Arcadian Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Services Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 3,632 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street, Suite 300 City: Oakland City: Oakland Zip: Zip: Last Updated: 2/28/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 24 of 190
25 Legal Entity Name: ARCADIAN HEALTH PLAN OF NEW YORK, INC. Contract Number: H3533 Organization Marketing Name: Northeast Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Service Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington St., Suite 300 City: Oakland City: Oakland Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARCADIAN HEALTH PLAN OF NORTH CAROLINA, INC. Contract Number: H2899 Organization Marketing Name: Southeast Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Service Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 2,628 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington St., Suite 300 City: Oakland City: Oakland Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARCADIAN HEALTH PLAN, INC. Contract Number: H0320 Organization Marketing Name: Desert Canyon Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 3,016 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 WASHINGTON STREET Suite 300 City: Oakland City: OAKLAND Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARCADIAN HEALTH PLAN, INC. Contract Number: H4529 Organization Marketing Name: Texas Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 11,887 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 WASHINGTON STREET, SUITE 300 City: Oakland City: OAKLAND Zip: Zip: Last Updated: 2/28/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 25 of 190
26 Legal Entity Name: ARCADIAN HEALTH PLAN, INC. Contract Number: H5416 Organization Marketing Name: Spokane Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Services Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 3,468 Address: 825 Washington St. Suite 300 Legal Entity Address: 824 WASHINGTON STREET, SUITE 300 City: Oakland City: OAKLAND State: WA Zip: Zip: Last Updated: 2/26/2008 Legal Entity Name: ARCADIAN HEALTH PLAN, INC. Contract Number: H5619 Organization Marketing Name: Northeast Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 4,034 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street, Suite 300 City: Oakland City: Oakland Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARCADIAN HEALTH PLAN, INC. Contract Number: H5783 Organization Marketing Name: Southeast Community Care Parent Organization: Arcadian Management Services Inc. Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 5,687 Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington Street, Suite 300 City: Oakland City: OAkland Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARIZONA PHYSICIANS IPA, INC. Contract Number: H0321 Organization Marketing Name: APIPA Personal Care Plus Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 15,334 Address: 3141 North 3rd Ave Legal Entity Address: 3141 North Third Avenue City: Phoenix City: Phoenix State: AZ State: AZ Zip: Zip: Last Updated: 12/18/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 26 of 190
27 Legal Entity Name: ARKANSAS BLUE CROSS AND BLUE SHIELD, A MUTUAL INS. Contract Number: H5849 Organization Marketing Name: Arkansas Blue Cross - Medi-Pak Advantage Parent Organization: Arkansas Blue Cross Blue Shield Organization Type: PFFS Plan Type: PFFS Manager Medicare Operations Name: Delena C Hicks Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 6,568 [email protected] Address: 320 W. Capitol, Suite 400 Legal Entity Address: 601 Gaines Street City: Little Rock City: Little Rock State: AR State: AR Zip: Zip: Last Updated: 2/3/2009 Legal Entity Name: ARKANSAS COMMUNITY CARE, INC. Contract Number: H5700 Organization Marketing Name: Arkansas Community Care, Inc. Parent Organization: Arcadian Management Services Inc. Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Dallas Enrollment: 7,590 [email protected] Address: 825 Washington St. Suite 300 Legal Entity Address: 825 Washington St. Suite 300 City: Oakland City: Oakland Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: ARTA MEDICARE HEALTH PLAN, INC. Contract Number: H5948 Organization Marketing Name: Arta Medicare Health Plan Parent Organization: ARTA MEDICARE HEALTH PLAN, INC. Vice President Operations Name: Karen Richmond Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 3333 Michelson Drive Suite 735 Legal Entity Address: 3333 Michelson Drive Suite 735 City: Irvine City: Irvine Zip: Zip: Last Updated: 9/9/2006 Legal Entity Name: ASOCIACION DE MAESTROS DE PUERTO RICO Contract Number: E6036 Organization Marketing Name: PROSSAM Plus Parent Organization: Asociacion De Maestros De Puerto Rico Organization Type: Employer/Union Only Direct Contract PFFS Plan Type: Employer/Union Only Direct Contract PFFS Name: Susana Garcia Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 2,025 [email protected] Address: 452 Ponce de Le n Ave. Legal Entity Address: 452 Ponce de Leon Ave City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 6/25/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 27 of 190
28 Legal Entity Name: ASURIS NORTHWEST HEALTH Contract Number: H5010 Organization Marketing Name: Asuris Northwest Health Parent Organization: The Regence Group Supr Ind Mktg Name: Shane Shown Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 1,451 Address: 1800 Ninth Ave Legal Entity Address: P.O. Box High Street SE City: Seattle City: Salem State: WA State: OR Zip: Zip: Last Updated: 12/15/2008 Legal Entity Name: ATRIO HEALTH PLANS Contract Number: H3814 Organization Marketing Name: ATRIO MyAdvantage Parent Organization: ATRIO Health Plans 7/1/2005 For Profit Marketing Manager Name: Rose Novak Phone: Contract Effective Date: Tax Status: 5386 CMS Region Responsible: Seattle Enrollment: 3,807 Address: 500 SE Cass Ave. Legal Entity Address: 500 SE CASS AVE Suite 230 Suite 230 City: Roseburg City: ROSEBURG State: OR State: OR Zip: Zip: Last Updated: 2/20/2009 Legal Entity Name: AVMED, INC Contract Number: H1016 Organization Marketing Name: AvMed Medicare Preferred Parent Organization: AvMed, Inc. Manager, Medicare Compliance Name: Jacqueline Crews Contract Effective Date: 9/1/1987 Phone: CMS Region Responsible: Atlanta Enrollment: 21,360 Address: AvMed Health Plans Legal Entity Address: 4300 N.W. 89TH BLVD NW 89 Blvd. City: Gainesville City: GAINESVILLE State: FL State: FL Zip: Zip: Last Updated: 6/27/2008 Legal Entity Name: AVMED, INC. Contract Number: H5436 Organization Marketing Name: AvMed Medicare Preferred PPO Parent Organization: AvMed, Inc. Manager, Medicare Compliance Name: Jacqueline Crews Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: Address: AvMed Health Plans Legal Entity Address: 4300 N.W. 89th BLVD 4300 NW 89 Blvd. City: Gainesville City: GAINESVILLE State: FL State: FL Zip: Zip: Last Updated: 6/27/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 28 of 190
29 Legal Entity Name: BANNER MEDISUN, INC. Contract Number: H0302 Organization Marketing Name: MediSunONE Parent Organization: Banner Health Name: Member Services Contract Effective Date: 8/1/1999 Phone: CMS Region Responsible: San Francisco Enrollment: 18,939 Address: P.O. Box 1489 Legal Entity Address: P.O. Box N. 99th Ave. Suite B North 99th Ave, Suite B City: Sun City City: Sun City State: AZ State: AZ Zip: Zip: Last Updated: 9/15/2008 Legal Entity Name: BANNER MEDISUN, INC. Contract Number: H5908 Organization Marketing Name: MediSun CareOptions Parent Organization: Banner Health Organization Type: PFFS Plan Type: PFFS Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 72 [email protected] Address: P.O. Box 1489 Legal Entity Address: P.O. Box N. 99th Ave. Suite B N. 99th Ave, Suite B City: Sun City City: Sun City State: AZ State: AZ Zip: Zip: Last Updated: 9/15/2008 Legal Entity Name: BIENVIVIR SENIOR HEALTH SERVICES Contract Number: H4518 Organization Marketing Name: Bienvivir Senior Health Services Parent Organization: Bienvivir Senior Health Services Organization Type: National PACE Plan Type: National PACE Chief Operations Officer Name: Margie Murphy Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: Dallas Enrollment: [email protected] Address: 2300 McKinley Legal Entity Address: 2300 McKinley City: El Paso City: EL PASO State: TX State: TX Zip: Zip: Last Updated: 9/13/2006 Legal Entity Name: BILLINGS CLINIC Contract Number: H2063 Organization Marketing Name: Billings Clinic PACE Parent Organization: Billings Clinic Organization Type:National PACE Plan Type:National PACE Contract Effective Date:10/1/2008 Tax Status:Not-for-Profit/Non-Profit CMS Region Responsible:Denver Enrollment:21 Legal Entity Address: 3155 Avenue C City:Billings State:MT Zip:59102 Director Name:Anne Gonzalez Phone: [email protected] Address:3155 Avenue C City:Billings State:MT Zip:59012 Last Updated:5/7/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 29 of 190
30 Legal Entity Name: BLUE CARE NETWORK OF MICHIGAN Contract Number: H5883 Organization Marketing Name: Blue Care Network Parent Organization: Blue Cross Blue Shield of Michigan Manager, Provider Affairs Name: Ashley Mabbitt Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 30,048 Address: Civic Center Dr. Legal Entity Address: Civic Center Drive City: Southfield City: Southfield State: MI State: MI Zip: Zip: Last Updated: 4/21/2009 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF ALABAMA Contract Number: H0104 Organization Marketing Name: Blue Cross Blue Shield of Alabama Parent Organization: BlueCross BlueShield of Alabama 7/1/2005 CMS Region Responsible: Atlanta Enrollment: 65,837 Senior Products Operations Manager Name: Sharon R Smith Phone: [email protected] Address: 450 Riverchase Parkway East Mail Stop F03020 City: Birmingham State: AL Zip: Last Updated: Contract Effective Date: Legal Entity Address: 450 RIVERCHASE PARKWAY EAST City: BIRMINGHAM State: AL Zip: /18/2009 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. Contract Number: H5434 Organization Marketing Name: Blue Cross and Blue Shield of Florida, Inc. Parent Organization: Blue Cross and Blue Shield of Florida Manager B - Contact SFl Name: Martha Garcia Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 12,957 [email protected] Address: 8400 NW 33rd St Legal Entity Address: 4800 DEERWOOD CAMPUS PARKWAY Suite 100 City: Miami City: JACKSONVILLE State: FL State: FL Zip: Zip: Last Updated: 4/1/2009 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC. Contract Number: H2230 Organization Marketing Name: Blue Cross and Blue Shield of Massachusetts Parent Organization: Blue Cross and Blue Shield of Massachusetts, Inc. Organization Type:Local CCP Plan Type:Local PPO Name: Member Services Contract Effective Date:9/1/2005 Phone: Tax Status:Not-for-Profit/Non-Profit CMS Region Responsible:Boston Enrollment:1,486 [email protected] Address: One Enterprise Drive Legal Entity Address: LANDMARK CENTER, 401 PARK DRIVE City: N. Quincy City:BOSTON State: MA State:MA Zip: Zip: Last Updated: 8/23/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 30 of 190
31 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF MA HMO BLUE, INC. Contract Number: H2261 Organization Marketing Name: Blue Cross and Blue Shield of Massachusetts Parent Organization: Blue Cross and Blue Shield of Massachusetts, Inc. Name: Member Services Contract Effective Date: 1/1/1996 Phone: CMS Region Responsible: Boston Enrollment: 31,566 Address: One Enterprise Drive Legal Entity Address: 401 PARK DRIVE City: N. Quincy City: BOSTON State: MA State: MA Zip: Zip: Last Updated: 2/1/2008 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF MASS. HMO BLUE, INC. Contract Number: H3011 Organization Marketing Name: Blue Cross and Blue Shield of Massachusetts Parent Organization: Blue Cross and Blue Shield of Massachusetts, Inc. Organization Type: PFFS Plan Type: PFFS Name: MEMBER SERVICES Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: Address: ONE ENTERPRISE DRIVE Legal Entity Address: 401 PARK DRIVE City: NORTH QUINCY City: BOSTON State: MA State: MA Zip: Zip: Last Updated: 5/1/2007 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND Contract Number: H4152 Organization Marketing Name: Blue Cross & Blue Shield of Rhode Island Parent Organization: Blue Cross & Blue Shield of Rhode Island Customer Service Department Name: Cust. Service Department Contract Effective Date: 1/1/1997 Phone: CMS Region Responsible: Boston Enrollment: 39,751 Address: 444 Westminster Street Legal Entity Address: 444 Westminster Street City: Providence City: PROVIDENCE State: RI State: RI Zip: Zip: Last Updated: 6/25/2007 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA Contract Number: H4205 Organization Marketing Name: Blue Cross Blue Shield of South Carolina Parent Organization: BlueCross BlueShield of South Carolina (BCBSSC) Organization Type:PFFS Plan Type:PFFS Contract Effective Date:6/1/2005 Tax Status:For Profit CMS Region Responsible:Atlanta Enrollment:4,832 Legal Entity Address: 2501 Faraway Drive City:COLUMBIA State:SC Zip:29223 Manager - Enrollment and Billing Name:Keyla Clark Phone: [email protected] Address:4101 Percival Road AX-G07 City:Columbia State:SC Zip:29229 Last Updated:12/26/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 31 of 190
32 Legal Entity Name: BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA Contract Number: H4209 Organization Marketing Name: Blue Cross Blue Shield of South Carolina Parent Organization: BlueCross BlueShield of South Carolina (BCBSSC) Manager - Enrollment and Billing Name: Keyla Clark Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 3,277 [email protected] Address: 4101 Percival Road Legal Entity Address: 2501 Faraway Drive AX-G07 City: Columbia City: COLUMBIA State: SC State: SC Zip: Zip: Last Updated: 12/26/2008 Legal Entity Name: BLUE CROSS BLUE SHIELD NORTHERN PLAINS ALLIANCE Contract Number: R5566 Organization Marketing Name: MedicareBlue PPO Parent Organization: Blue Cross and Blue Shield of Minnesota Organization Type: Regional CCP Plan Type: Regional PPO Name: Member Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Kansas City Enrollment: 22,371 [email protected] Address: MedicareBlue PPO Legal Entity Address: 3400 Yankee Drive, R Market Street - Sp-2nd Flr City: Philadelphia City: Eagan State: PA State: MN Zip: Zip: Last Updated: 5/19/2008 Legal Entity Name: BLUE CROSS BLUE SHIELD OF FLORIDA, INC. Contract Number: H3518 Organization Marketing Name: Blue Cross and Blue Shield of Florida, Inc. Parent Organization: Blue Cross and Blue Shield of Florida Organization Type: PFFS Plan Type: PFFS Manager B - Contact SFl Name: Martha Garcia Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 1,917 [email protected] Address: 8400 NW 33rd St Legal Entity Address: 4800 Deerwood Campus Parkway Suite 100 DCC 100, 8th Floor City: Miami City: Jacksonville State: FL State: FL Zip: Zip: Last Updated: 4/1/2009 Legal Entity Name: BLUE CROSS BLUE SHIELD OF GEORGIA Contract Number: H5422 Organization Marketing Name: Blue Cross Blue Shield Healthcare Plan of Georgia Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 1,649 [email protected] Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 32 of 190
33 Legal Entity Name: BLUE CROSS BLUE SHIELD OF MICHIGAN Contract Number: H2319 Organization Marketing Name: Blue Cross Blue Shield of Michigan Parent Organization: Blue Cross Blue Shield of Michigan Organization Type: PFFS Plan Type: PFFS Name: Customer Inquiry Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 276,536 Address: West Eleven Mile Road Legal Entity Address: 600 Lafayette East H 404 City: Southfield City: Detroit State: MI State: MI Zip: Zip: Last Updated: 7/12/2007 Legal Entity Name: BLUE CROSS BLUE SHIELD OF MINNESOTA Contract Number: H2461 Organization Marketing Name: Blue Cross Blue Shield of Minnesota Parent Organization: Blue Cross and Blue Shield of Minnesota Organization Type: 1876 Cost Plan Type: 1876 Cost Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 3400 Yankee Drive Legal Entity Address: 3400 Yankee Drive City: Eagan City: Eagan State: MN State: MN Zip: Zip: Last Updated: 9/11/2006 Legal Entity Name: BLUE CROSS BLUE SHIELD OF TENNESSEE Contract Number: H7917 Organization Marketing Name: BlueCross BlueShield of Tennessee Parent Organization: BlueCross BlueShield of Tennessee Supervisor Medicare Advantage Operations Name: Carol Troxell Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 5,228 [email protected] Address: 801 Pine Street Legal Entity Address: 801 Pine Street City: Chattanooga City: Chattanooga State: TN State: TN Zip: Zip: Last Updated: 2/22/2007 Legal Entity Name: BLUE CROSS OF CALIFORNIA Contract Number: H0564 Organization Marketing Name: Anthem Blue Cross Parent Organization: Wellpoint, Inc. Contract Effective Date: 6/1/1993 Phone: CMS Region Responsible: Chicago Enrollment: 17,084 [email protected] Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 33 of 190
34 Legal Entity Name: BLUE CROSS OF CALIFORNIA Contract Number: H5419 Organization Marketing Name: Anthem Blue Cross Parent Organization: Wellpoint, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 2/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 9,874 Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: BLUE CROSS OF IDAHO HEALTH SERVICES, INC Contract Number: H1350 Organization Marketing Name: Blue Cross of Idaho Parent Organization: Blue Cross of Idaho Health Services, Inc. 9/1/1997 Member Services Manager Name: Sheri Core Phone: Contract Effective Date: CMS Region Responsible: Seattle Enrollment: 20,818 [email protected] Address: 3000 E. Pine Ave. Legal Entity Address: 3000 E. PINE AVE. City: Meridian City: MERIDIAN State: ID State: ID Zip: Zip: Last Updated: 8/27/2007 Legal Entity Name: BLUE CROSS OF IDAHO HEALTH SERVICES, INC. Contract Number: H5862 Organization Marketing Name: Blue Cross of Idaho Parent Organization: Blue Cross of Idaho Health Services, Inc. Organization Type: PFFS Plan Type: PFFS Customer Service Manager, Medicare Advantage Plans Name: Sheri Core Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Seattle Enrollment: 1,286 [email protected] Address: 3000 E. Pine Ave. Legal Entity Address: 3000 E. Pine Avenue City: Meridian City: Meridian State: ID State: ID Zip: Zip: Last Updated: 8/27/2007 Legal Entity Name: BLUE CROSS OF IDAHO HLTH SERVICES INC Contract Number: H1302 Organization Marketing Name: Blue Cross of Idaho Parent Organization: Blue Cross of Idaho Health Services, Inc. Medicare Advantage Customer Service Name: Sheri Core Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: [email protected] Address: 3000 E. Pine Ave. Legal Entity Address: 3000 E Pine Ave City: Meridian City: MERIDIAN State: ID State: ID Zip: Zip: Last Updated: 8/27/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 34 of 190
35 Legal Entity Name: BLUE PLUS Contract Number: H2425 Organization Marketing Name: Blue Plus Parent Organization: Blue Cross and Blue Shield of Minnesota Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 9,996 Address: 3400 Yankee Drive Legal Entity Address: P.O. BOX City: Eagan City: ST PAUL State: MN State: MN Zip: Zip: Last Updated: 10/4/2006 Legal Entity Name: BLUECROSS BLUESHIELD OF TENNESSEE Contract Number: H4979 Organization Marketing Name: BlueCross BlueShield of Tennessee Parent Organization: BlueCross BlueShield of Tennessee Organization Type: PFFS Plan Type: PFFS 1/1/2009 CMS Region Responsible: Atlanta Enrollment: 1,805 Supervisor Medicare Advantage Operations Name: Carol Troxell Phone: Address: 801 Pine Street Contract Effective Date: Legal Entity Address: 801 Pine Street City: Chattanooga City: Chattanooga State: TN State: TN Zip: Zip: Last Updated: 12/27/2007 Legal Entity Name: BLUECROSS BLUESHIELD OF TENNESSEE Contract Number: H5884 Organization Marketing Name: BlueCross BlueShield of Tennessee Parent Organization: BlueCross BlueShield of Tennessee Organization Type: PFFS Supervisor Medicare Advantage Operations Plan Type: PFFS Name: Carol Troxell Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Atlanta Enrollment: 22,492 Address: 801 Pine Street Legal Entity Address: 801 Pine Street City: Chattanooga City: Chattanooga State: TN State: TN Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: BORO MEDICAL CENTER Contract Number: H6331 Organization Marketing Name: Boro Medical, P.C. Parent Organization: Boro Medical Center Organization Type: HCPP Cost Plan Type: HCPP Cost Name: Cinthya Vargas Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: New York Enrollment: 1,722 [email protected] Address: Steinway Street Legal Entity Address: Steinway Street City: Astoria City: Astoria State: NY State: NY Zip: Zip: Last Updated: 8/31/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 35 of 190
36 Legal Entity Name: BRAVO HEALTH INSURANCE COMPANY, INC. Contract Number: H7406 Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: 3601 O'Donnell Street Legal Entity Address: 3601 O'Donnell Street City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 8/23/2007 Legal Entity Name: BRAVO HEALTH INSURANCE COMPANY, INC. Contract Number: H1355 Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Philadelphia Enrollment: 12 Address: 3601 O'Donnell Street Legal Entity Address: 3601 O'Donnell Street City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 3/6/2008 Legal Entity Name: BRAVO HEALTH MID- ATLANTIC INC. Contract Number: H2108 Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc. Contract Effective Date: 1/1/2001 Phone: CMS Region Responsible: Philadelphia Enrollment: 12,010 Address: 3601 O'Donnell Street Legal Entity Address: 3601 O'Donnell Street City: Baltimore City: BALTIMORE State: MD State: MD Zip: Zip: Last Updated: 8/23/2007 Legal Entity Name: BRAVO HEALTH MID- ATLANTIC INC. Contract Number: H6421 Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: 3601 O'Donnell Street Legal Entity Address: 3601 O'Donnell Street City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 8/23/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 36 of 190
37 Legal Entity Name: BRAVO HEALTH PENNSYLVANIA INC. Contract Number: H3949 Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc. Name: Member Services Contract Effective Date: 2/1/1992 Phone: CMS Region Responsible: Philadelphia Enrollment: 18,707 Address: 3601 O'Donnell Street Legal Entity Address: 1500 Spring Garden Street, Suite 800 City: Baltimore City: PHILADELPHIA State: MD State: PA Zip: Zip: Last Updated: 8/23/2007 Legal Entity Name: BRAVO HEALTH PENNSYLVANIA, INC. Contract Number: H3964 Organization Marketing Name: Senior Partners Parent Organization: Bravo Health, Inc. Name: Member Services Contract Effective Date: 1/1/1997 Phone: CMS Region Responsible: Philadelphia Enrollment: 22,956 Address: 3601 O'Donnell Street Legal Entity Address: 3601 O'Donnell Street City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 9/12/2008 Legal Entity Name: BRAVO HEALTH TEXAS, INC. Contract Number: H4528 Organization Marketing Name: Bravo Health Parent Organization: Bravo Health, Inc. Name: Member Services Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: 13,721 Address: 3601 O'Donnell Street Legal Entity Address: WEST AVENUE City: Baltimore City: SAN ANTONIO State: MD State: TX Zip: Zip: Last Updated: 8/23/2007 Legal Entity Name: BRIDGEWAY HEALTH SOLUTIONS Contract Number: H5590 Organization Marketing Name: Advantage by Bridgeway Health Solutions Parent Organization: Centene Corporation Director Name: Elaine Teune Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: Address: 1501 W Fountainhead Parkway Legal Entity Address: West Fountainhead Parkway suite #201 City: Tempe City: Tempe State: AZ State: AZ Zip: Zip: Last Updated: 5/31/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 37 of 190
38 Legal Entity Name: BUCKEYE COMMUNITY HEALTH PLAN, INC. Contract Number: H0908 Organization Marketing Name: Advantage by Buckeye Community Health Plan Parent Organization: Centene Corporation Contract Effective Date: 1/1/2008 CMS Region Responsible: Dallas Enrollment: 140 Legal Entity Address: U.S. Bank Building, Suite South Third Street City: Columbus State: OH Zip: Legal Entity Name: C AND O EMPLOYEES' HOSPITAL ASSOCIATION Contract Number: H4906 Organization Marketing Name: C and O Employees' Hospital Association Parent Organization: C & O Employees' Hospital Association Organization Type: HCPP Cost Plan Type: HCPP Cost Contract Effective Date: 5/1/1999 CMS Region Responsible: Philadelphia Enrollment: 2,850 Legal Entity Address: 511 MAIN STREET, 2ND FLOOR City: CLIFTON FORGE State: VA Zip: Legal Entity Name: CALIFORNIA PHYSICIANS' SERVICE Contract Number: H0504 Organization Marketing Name: Blue Shield of California Parent Organization: Blue Shield of California Contract Effective Date: 5/1/1996 CMS Region Responsible: San Francisco Enrollment: 40,400 Legal Entity Address: 6300 CANOGA AVENUE City: WOODLAND HILLS Zip: Legal Entity Name: CAMBRIDGE LIFE INSURANCE COMPANY Contract Number: H5952 Organization Marketing Name: Advantra«Freedom Parent Organization: Coventry Health Care Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2007 CMS Region Responsible: Denver Enrollment: 1,299 Legal Entity Address: 6705 Rockledge Drive Suite 900 City: Bethesda State: MD Zip: Sr Marketing Analyst Name: Todd McCollough Phone: [email protected] Address: 175 South Third Street Suite 1200 City: Columbus State: OH Zip: Last Updated: 9/10/2008 Dues Clerk Name: Margaret Brown Phone: [email protected] Address: 511 Main Street, 2nd Floor City: Clifton Forge State: VA Zip: Last Updated: 9/28/2007 Name: Member Services Phone: [email protected] Address: 6300 Canoga Avenue City: Woodland Hills Zip: Last Updated: 7/9/2007 Customer Service Name: Advantra Freedom Phone: [email protected] Address: Advantra Freedom/Coventry Health Care, Inc PO Box 7154 City: London State: KY Zip: Last Updated: 2/28/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 38 of 190
39 Legal Entity Name: CAPITAL ADVANTAGE INSURANCE COMPANY Contract Number: H3923 Organization Marketing Name: Capital Advantage Insurance Company Parent Organization: Capital BlueCross Customer Service Manager Name: Jayne Dailey Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: 9,561 Address: 2500 Elmerton Avenue Legal Entity Address: 2500 ELMERTON AVENUE City: Harrisburg City: HARRISBURG State: PA State: PA Zip: Zip: Last Updated: 5/27/2009 Legal Entity Name: CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. Contract Number: H3388 Organization Marketing Name: CDPHP Medicare Choices Parent Organization: Capital District Physicians' Health Plan, Inc. 8/1/1999 CMS Region Responsible: New York Enrollment: 20,840 Manager, Member Services Name: Laura Kordas Phone: Address: 500 Patroon Creek Blvd Contract Effective Date: Legal Entity Address: 500 Patroon Creek Blvd City: Albany City: ALBANY State: NY State: NY Zip: Zip: Last Updated: 2/1/2008 Legal Entity Name: CAPITAL HEALTH PLAN Contract Number: H5938 Organization Marketing Name: Capital Health Plan Parent Organization: Blue Cross and Blue Shield of Florida Network Services Supervisor Name: Beth Maige Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Atlanta Enrollment: 9,131 Address: P.O. Box Legal Entity Address: 2140 CENTERVILLE PLACE City: Tallahassee City: TALLAHASSEE State: FL State: FL Zip: Zip: Last Updated: 4/13/2009 Legal Entity Name: CARE IMPROVEMENT PLUS OF MARYLAND, INC. Contract Number: H5665 Organization Marketing Name: Care Improvement Plus Parent Organization: XLHealth Corporation Marketing Manager Name: Misty Smith Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Philadelphia Enrollment: 1,173 Address: 351 West Camden Street Legal Entity Address: 351 West Camden Street. Suite 100 Suite 100 City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 4/16/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 39 of 190
40 Legal Entity Name: CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY Contract Number: H0084 Organization Marketing Name: Care Improvement PPO Parent Organization: XLHealth Corporation Marketing Manager Name: Misty Smith Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Philadelphia Enrollment: * [email protected] Address: 351 West Camden Street Legal Entity Address: 351 West Camden Street Suite 100 Suite 100 City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 4/16/2009 Legal Entity Name: CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY Contract Number: R6801 Organization Marketing Name: Care Improvement Plus Parent Organization: XLHealth Corporation Organization Type: Regional CCP Plan Type: Regional PPO 1/1/2007 For Profit CMS Region Responsible: Philadelphia Enrollment: 14,820 Marketing Manager Name: Misty Smith Phone: [email protected] Address: 351 West Camden Street Contract Effective Date: Tax Status: 8701 Legal Entity Address: 351 West Camden Street Suite 100 Suite 100 City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 2/25/2009 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO Contract Number: R9896 Organization Marketing Name: Care Improvement Plus Parent Organization: XLHealth Corporation Organization Type: Regional CCP Plan Type: Regional PPO Marketing Manager Name: Misty Smith Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: 30,085 [email protected] Address: 351 West Camden Street Legal Entity Address: 351 West Camden Street Suite 100 Suite 100 City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 4/16/2009 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. Contract Number: H6528 Organization Marketing Name: Care Improvement PPO Parent Organization: XLHealth Corporation Marketing Manager Name: Misty Smith Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Philadelphia Enrollment: * [email protected] Address: 351 West Camden Street Legal Entity Address: 351 West Camden Street Suite 100 Suite 100 City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 4/16/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 40 of 190
41 Legal Entity Name: CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. Contract Number: R3444 Organization Marketing Name: Care Improvement Plus Parent Organization: XLHealth Corporation Organization Type: Regional CCP Plan Type: Regional PPO Marketing Manager Name: Misty Smith Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: 9,036 Address: 351 West Camden Street Legal Entity Address: 351 West Camden Street Suite 100 Suite 100 City: Baltimore City: Baltimore State: MD State: MD Zip: Zip: Last Updated: 4/16/2009 Legal Entity Name: CARE N' CARE INSURANCE COMPANY, INC. Contract Number: H6328 Organization Marketing Name: Care N' Care Health Plan Parent Organization: North Texas Specialty Physicians Chief Operating Officer Name: Brad Larson Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 1701 River Run Legal Entity Address: 1701 River Run Suite 402 Suite 402 City: Fort Worth City: Fort Worth State: TX State: TX Zip: Zip: Last Updated: 4/15/2009 Legal Entity Name: CARE PLUS HEALTH PLAN Contract Number: H1019 Organization Marketing Name: CarePlus Health Plans, Inc. Parent Organization: Humana Inc. Contract Effective Date: 2/1/1998 Phone: CMS Region Responsible: Kansas City Enrollment: 62,740 Address: 101 East Main Street Legal Entity Address: NW 20th Street Suite 300 City: Louisville City: Doral State: KY State: FL Zip: Zip: Last Updated: 3/23/2009 Legal Entity Name: CARE RESOURCES, INC. Contract Number: H5610 Organization Marketing Name: Care Resources Parent Organization: CARE RESOURCES, INC. Organization Type: National PACE Plan Type: National PACE Claims Manager Name: Becky Haggerty Contract Effective Date: 9/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: inc.com Address: 2100 Raybrook Ave SE Legal Entity Address: 1471 Grace Street SE Suite 203 City: Grand Rapids City: Grand Rapids State: MI State: MI Zip: Zip: Last Updated: 4/3/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 41 of 190
42 Legal Entity Name: CARE WISCONSIN HEALTH PLAN, INC. Contract Number: H5209 Organization Marketing Name: Care Wisconsin Health Plan, Inc. Parent Organization: Care Wisconsin First, Inc. Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Chicago Enrollment: Address: 2802 International Lane Legal Entity Address: 2802 INTERNATIONAL LANE P.O. Box PO BOX City: Madison City: MADISON State: WI State: WI Zip: Zip: Last Updated: 4/30/2009 Legal Entity Name: CARE WISCONSIN HEALTH PLAN, INC. Contract Number: H7475 Organization Marketing Name: Care Wisconsin Health Plan, Inc. Parent Organization: Care Wisconsin First, Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 80 Address: 2802 International Lane Legal Entity Address: 2802 International Lane P.O. Box PO Box City: Madison City: Madison State: WI State: WI Zip: Zip: Last Updated: 4/30/2009 Legal Entity Name: CARE1ST HEALTH PLAN Contract Number: H5928 Organization Marketing Name: Care1st Medicare Advantage Plan Parent Organization: Care1st Health Plan Pharmacy Director Name: Michael Lasconia Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 11,616 Address: 601 Potrero Grande Drive Legal Entity Address: 601 Potrero Grande City: Monterey Park City: Monterey Park Zip: Zip: Last Updated: 7/2/2007 Legal Entity Name: CARE1ST HEALTH PLAN OF ARIZONA Contract Number: H5430 Organization Marketing Name: ONECare by Care1st Health Plan Arizona, Inc. Parent Organization: Care1st Health Plan Compliance Officer Name: Cheyenne Hollin Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,503 Address: 2355 E. Camelback Rd., Ste 300 Legal Entity Address: 2355 E. CAMELBACK ROAD, SUITE 300 City: Phoenix City: PHOENIX State: AZ State: AZ Zip: Zip: Last Updated: 10/8/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 42 of 190
43 Legal Entity Name: CAREMORE HEALTH PLAN Contract Number: H0544 Organization Marketing Name: CareMore Health Plan Parent Organization: CareMore Medical Enterprises Contract Effective Date: 2/1/2003 CMS Region Responsible: San Francisco Enrollment: 32,298 Legal Entity Address: Park Plaza Drive SUITE 150 City: CERRITOS Zip: Legal Entity Name: CARESOURCE Contract Number: H6178 Organization Marketing Name: CareSource Parent Organization: CareSource Contract Effective Date: 1/1/2008 CMS Region Responsible: Chicago Enrollment: 314 Legal Entity Address: One Dayton Centre, 20th Floor One South Main Street City: Dayton State: OH Zip: Legal Entity Name: CARESOURCE MICHIGAN Contract Number: H0141 Organization Marketing Name: CareSource Parent Organization: CareSource Contract Effective Date: 1/1/2008 CMS Region Responsible: Chicago Enrollment: 85 Legal Entity Address: 2369 Woodlake Drive, Suite 200 City: Okemos State: MI Zip: Legal Entity Name: CARITEN HEALTH PLAN IN Contract Number: H4461 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/1998 CMS Region Responsible: Kansas City Enrollment: 48,614 Legal Entity Address: 500 West Main St City: Louisville State: KY Zip: Director of Enrollment and Membership Name: Alicia Wheeler Phone: Address: Park Plaza Drive Suite 150 City: Cerritos Zip: Last Updated: 12/29/2008 Director of Communications Name: Michelle Chapman Phone: Address: P. O. Box 8738 City: Dayton State: OH Zip: Last Updated: 3/4/2009 Director of Communications Name: Michelle Chapman Phone: Address: P. O. Box 8738 City: Dayton State: OH Zip: Last Updated: 3/6/2009 Phone: Address: 101 East Main Street City: Louisville State: KY Zip: Last Updated: 2/11/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 43 of 190
44 Legal Entity Name: CARITEN INSURANCE COMPANY Contract Number: H5523 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Kansas City Enrollment: 87 Address: 101 East Main Street Legal Entity Address: 500 West Main St City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 2/18/2009 Legal Entity Name: CATHOLIC SPECIAL NEEDS PLAN, LLC Contract Number: H1777 Organization Marketing Name: ArchCare Advantage Parent Organization: Catholic Health Care System, Inc. 1/1/2008 Director of Operations Name: Khaibah Stuart Phone: Contract Effective Date: CMS Region Responsible: New York Enrollment: Address: 155 E 56 ST Legal Entity Address: 1339 York Avenue 2ND FLOOR City: New York State: NY Zip: Last Updated: City: New York State: NY Zip: /24/2009 Legal Entity Name: CDPHP UNIVERSAL BENEFITS, INC. Contract Number: H5042 Organization Marketing Name: CDPHP Medicare Choices Parent Organization: Capital District Physicians' Health Plan, Inc. Manager, Member Services Name: Laura Kordas Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 2,347 [email protected] Address: 500 Patroon Creek Blvd Legal Entity Address: 500 Patroon Creek Blvd. City: Albany City: Albany State: NY State: NY Zip: Zip: Last Updated: 2/1/2008 Legal Entity Name: CENTER FOR ELDERS INDEPENDENCE Contract Number: H5405 Organization Marketing Name: Center For Elders Independence Parent Organization: Center For Elders Independence Organization Type: National PACE IT Manager Plan Type: National PACE Name: David S Virgo Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: th St., Suite 400 Legal Entity Address: th St., Suite 400 City: Oakland City: OAKLAND Zip: Zip: Last Updated: 3/4/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 44 of 190
45 Legal Entity Name: CENTRA HEALTH, INC. Contract Number: H8096 Organization Marketing Name: Centra PACE Parent Organization: Centra Health, Inc. Organization Type: National PACE Centra PACE Program Director Plan Type: National PACE Name: Debra M Maddox Contract Effective Date: 2/1/2009 Phone: CMS Region Responsible: Philadelphia Enrollment: 11 [email protected] Address: 407 Federal Street Legal Entity Address: 407 Federal Street City: Lynchburg City: Lynchburg State: VA State: VA Zip: Zip: Last Updated: 8/25/2008 Legal Entity Name: CENTRAL HEALTH PLAN OF CALIFORNIA, INC. Contract Number: H5649 Organization Marketing Name: Central Health Medicare Plan Parent Organization: Central Health Plan of California Member Services Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 4,500 [email protected] Address: 1540 Bridgegate Drive Legal Entity Address: 1540 Bridgegate Drive City: Diamond Bar City: Diamond Bar Zip: Zip: Last Updated: 1/7/2009 Legal Entity Name: CHEROKEE NATION COMPREHENSIVE CARE AGENCY Contract Number: H4142 Organization Marketing Name: Cherokee Elder Care Parent Organization: Cherokee Nation Comprehensive Care Agency Organization Type: National PACE Plan Type: National PACE Finance Director Name: Thelma Pittman Contract Effective Date: 8/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 24 [email protected] Address: 1387 W 4th St. Legal Entity Address: 1387 W 4th St. City: Tahlequah City: Tahlequah State: OK State: OK Zip: Zip: Last Updated: 3/6/2008 Legal Entity Name: CHINESE COMMUNITY HEALTH PLAN Contract Number: H0571 Organization Marketing Name: Chinese Community Health Plan Parent Organization: Chinese Hospital Association Member Services Manager Name: Irene Louie Contract Effective Date: 8/1/1994 Phone: CMS Region Responsible: San Francisco Enrollment: 7,282 [email protected] Address: 835 Jackson Street Legal Entity Address: 445 Grant Avenue Suite 700 City: San Francisco City: SAN FRANCISCO Zip: Zip: Last Updated: 11/21/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 45 of 190
46 Legal Entity Name: CIGNA HEALTHCARE OF ARIZONA, INC. Contract Number: H0354 Organization Marketing Name: CIGNA Medicare Select Parent Organization: CIGNA Name: Medicare Team Contract Effective Date: 12/1/1992 Phone: CMS Region Responsible: Kansas City Enrollment: 33,489 Address: P.O. Box Legal Entity Address: N. BLACK CANYON HIGHWAY City: Phoenix City: PHOENIX State: AZ State: AZ Zip: Zip: Last Updated: 3/29/2007 Legal Entity Name: CIGNA HEALTHCARE OF ARIZONA, INC. Contract Number: H5179 Organization Marketing Name: CIGNA Medicare Access Parent Organization: CIGNA Organization Type: PFFS Plan Type: PFFS Name: Medicare Team Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: Address: Medicare Team Legal Entity Address: N. Black Canyon Highway P.O. Box City: Phoenix City: Phoenix State: AZ State: AZ Zip: Zip: Last Updated: 2/23/2007 Legal Entity Name: CITIZENS CHOICE HEALTHPLAN Contract Number: H3815 Organization Marketing Name: Citizens Choice Healthplan Parent Organization: Honored Citizens Choice Health Plan Chief Operations Officer Name: Elizabeth Tejada Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 7,784 Address: Studebaker Road Suite 200 Legal Entity Address: Studebaker Road Suite 200 City: Cerritos City: Cerritos Zip: Zip: Last Updated: 9/8/2008 Legal Entity Name: CITRUS HEALTH CARE, INC. Contract Number: H5407 Organization Marketing Name: Citrus Health Care, Inc. Parent Organization: Citrus Health Care, Inc. CIO Name: Upen Patel Contract Effective Date: 6/1/2004 Phone: CMS Region Responsible: Atlanta Enrollment: 14,590 Address: 5420 Bay Center Drive Legal Entity Address: 5420 BAY CENTER DRIVE Suite 250 SUITE 250 City: Tampa City: TAMPA State: FL State: FL Zip: Zip: Last Updated: 3/3/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 46 of 190
47 Legal Entity Name: CLARIAN HEALTH PLANS, INC. Contract Number: H1553 Organization Marketing Name: Clarian Health Plans, Inc. - Senior Smart Choice Parent Organization: The M Plan Inc. Organization Type: 1876 Cost Customer Solutions Center Manager Plan Type: 1876 Cost Name: Trina Gibson Contract Effective Date: 1/1/1993 Phone: CMS Region Responsible: Chicago Enrollment: 5,114 [email protected] Address: 1776 N. Meridian Street Legal Entity Address: 1776 N. Meridian, Suite 300 Suite 300 City: Indianapolis City: Indianapolis State: IN State: IN Zip: Zip: Last Updated: 3/18/2009 Legal Entity Name: CLARIAN HEALTH PLANS, INC. Contract Number: H7220 Organization Marketing Name: Clarian Health Plans, Inc. - Clarian Medicare Parent Organization: Clarian Health Partners, Inc. 1/1/2009 CMS Region Responsible: Chicago Enrollment: 1,364 Customer Solutions Center Manager Name: Trina Gibson Phone: [email protected] Address: 1776 N. Meridian Street Contract Effective Date: Legal Entity Address: 1776 N. Meridian Street, Suite 300 Suite 300 City: Indianapolis City: Indianapolis State: IN State: IN Zip: Zip: Last Updated: 2/23/2009 Legal Entity Name: CLEAR CHOICE HEALTH PLANS, INC. Contract Number: H0427 Organization Marketing Name: Clear Choice Health Plans Parent Organization: Clear Choice Health Plans, Inc. Medicare Marketing Manager Name: Brad Westphal Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Seattle Enrollment: * [email protected] Address: 2965 NE Conners Ave. Legal Entity Address: 2965 NE Conners Ave. City: Bend City: Bend State: OR State: OR Zip: Zip: Last Updated: 7/10/2008 Legal Entity Name: CLEAR CHOICE HEALTH PLANS, INC. Contract Number: H3864 Organization Marketing Name: Clear One Health Plans Parent Organization: Clear Choice Health Plans, Inc. Medicare Marketing Manager Name: Brad Westphal Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Seattle Enrollment: 10,596 [email protected] Address: 2965 NE Conners Ave. Legal Entity Address: 2965 NE Conners Ave. City: Bend City: BEND State: OR State: OR Zip: Zip: Last Updated: 7/10/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 47 of 190
48 Legal Entity Name: COLORADO ACCESS Contract Number: H0621 Organization Marketing Name: Colorado Access Parent Organization: Colorado Access Provider Contracting Manager Name: Tammie Fickas Contract Effective Date: 2/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 3,250 Address: E. Harvard Ave Legal Entity Address: EAST HARVARD AVENUE Suite 600 SUITE 600 City: Denver City: DENVER State: CO State: CO Zip: Zip: Last Updated: 1/30/2009 Legal Entity Name: COLORADO CHOICE HEALTH PLANS Contract Number: H0657 Organization Marketing Name: San Luis Valley HMO Parent Organization: HMO Health Plans, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost 1/1/1994 Medicare Coordinator Name: Dessa Pottberg Phone: Contract Effective Date: CMS Region Responsible: Denver Enrollment: Address: 700 Main Street, Suite 100 Legal Entity Address: 700 Main Street, Suite 100 City: Alamosa City: Alamosa State: CO State: CO Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: COMMONWEALTH CARE ALLIANCE, INC. Contract Number: H2225 Organization Marketing Name: Commonwealth Care Alliance, Inc. Parent Organization: Commonwealth Care Alliance Name: Kara Curtis Contract Effective Date: 6/1/2004 Phone: CMS Region Responsible: Boston Enrollment: 1,995 Address: 30 Winter Street Legal Entity Address: 30 WINTER STREET City: Boston City: BOSTON State: MA State: MA Zip: Zip: Last Updated: 5/13/2008 Legal Entity Name: COMMUNITY CARE HEALTH PLAN, INC Contract Number: H5207 Organization Marketing Name: Community Care Parent Organization: Community Care, Inc. Marketing Manager Name: Julie Erdmann Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Chicago Enrollment: Address: 1555 S. Layton Blvd. Legal Entity Address: 1555 S. Layton Blvd. City: Milwaukee City: Milwaukee State: WI State: WI Zip: Zip: Last Updated: 5/4/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 48 of 190
49 Legal Entity Name: COMMUNITY CARE HEALTH PLAN, INC. Contract Number: H2034 Organization Marketing Name: Community Care Parent Organization: Community Care, Inc. Marketing Manager Name: Julie Erdmann Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 19 Address: 1555 S. Layton Blvd. Legal Entity Address: 1555 S Layton Blvd City: Milwaukee City: Milwaukee State: WI State: WI Zip: Zip: Last Updated: 5/4/2007 Legal Entity Name: COMMUNITY CARE HMO, INC Contract Number: H3755 Organization Marketing Name: CommunityCare Senior Health Plan Parent Organization: CommunityCare Managed Healthcare Plans of OK, Inc. Name: Pat Hall Contract Effective Date: 5/1/1996 Phone: CMS Region Responsible: Dallas Enrollment: 26,592 [email protected] Address: 218 W 6th Street Legal Entity Address: 218 W. 6TH STREET City: Tulsa City: TULSA State: OK State: OK Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: COMMUNITY CARE, INC. Contract Number: H5212 Organization Marketing Name: Community Care Parent Organization: Community Care, Inc. Organization Type: National PACE Marketing Manager Plan Type: National PACE Name: Julie Erdmann Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 1555 S. Layton Blvd. Legal Entity Address: 1555 S. Layton Blvd. City: Milwaukee City: Milwaukee State: WI State: WI Zip: Zip: Last Updated: 5/4/2007 Legal Entity Name: COMMUNITY ELDERCARE OF SAN DIEGO Contract Number: H5629 Organization Marketing Name: St. Paul's PACE Parent Organization: Community Eldercare of San Diego Organization Type: National PACE Plan Type: National PACE Executive Director Name: John A Allgood Contract Effective Date: 2/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: 57 [email protected] Address: 328 Maple Street Legal Entity Address: 328 Maple Street City: San Diego City: San Diego Zip: Zip: Last Updated: 1/23/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 49 of 190
50 Legal Entity Name: COMMUNITY HEALTH GROUP Contract Number: H7086 Organization Marketing Name: Community Health Group Parent Organization: Community Health Group Chief Information Officer Name: Jonathan Tamayo Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 740 Bay Blvd. Legal Entity Address: 740 BAY BOULEVARD City: Chula Vista City: CHULA VISTA Zip: Zip: Last Updated: 3/6/2007 Legal Entity Name: COMMUNITY HEALTH PLAN OF WASHINGTON Contract Number: H5826 Organization Marketing Name: Community HealthFirst Medicare Advantage Plan Parent Organization: Community Health Plan of Washington 1/1/2007 Director of Medicare Sales Name: Kris Pringle Phone: Contract Effective Date: CMS Region Responsible: Seattle Enrollment: 3,804 Address: 720 Olive Way Legal Entity Address: 720 Olive Way Suite 300 Suite 300 City: Seattle City: Seattle State: WA State: WA Zip: Zip: Last Updated: 5/6/2008 Legal Entity Name: COMMUNITY INSURANCE COMPANY Contract Number: H3655 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 10/1/1994 Phone: CMS Region Responsible: Chicago Enrollment: 78,512 Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: COMMUNITY INSURANCE COMPANY Contract Number: H5529 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: 8,514 [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way OHO205-A037 CAT201-C004 City: Mason City: Thousand Oaks State: OH State: OH Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 50 of 190
51 Legal Entity Name: COMPCARE HEALTH SERVICES INSURANCE CORPORATION Contract Number: H6184 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 57 Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: COMPREHENSIVE CARE MANAGEMENT CORP. Contract Number: H3329 Organization Marketing Name: Comprehensive Care Management Corp. Parent Organization: Bethco Corporation Organization Type: National PACE Plan Type: National PACE 11/1/2003 CMS Region Responsible: New York Enrollment: 2,006 Name: Felice Liburd Contract Effective Date: Phone: [email protected] Address: 2275 Olinville Avenue Legal Entity Address: 612 ALLERTON AVENUE City: Bronx City: BRONX State: NY State: NY Zip: Zip: Last Updated: 3/17/2009 Legal Entity Name: COMPREHENSIVE CARE MANAGEMENT CORP. Contract Number: H5989 Organization Marketing Name: Comprehensive Care Management Corp. Parent Organization: Bethco Corporation Name: Felice Liburd Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 20 [email protected] Address: 2275 Olinville Avenue Legal Entity Address: 612 Allerton Avenue City: Bronx City: Bronx State: NY State: NY Zip: Zip: Last Updated: 3/17/2009 Legal Entity Name: CONCORDIA CARE Contract Number: H3613 Organization Marketing Name: Concordia Care Parent Organization: Concordia Care Organization Type: National PACE Project Leader Plan Type: National PACE Name: Anne Messer Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 2373 Euclid Heights Blvd Legal Entity Address: 2373 EUCLID HEIGHTS BOULEVARD City: Cleveland Heights City: CLEVELAND HEIGHTS State: OH State: OH Zip: Zip: Last Updated: 4/29/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 51 of 190
52 Legal Entity Name: CONNECTICARE INSURANCE COMPANY, INC. Contract Number: H6504 Organization Marketing Name: ConnectiCare Insurance Company, Inc. Parent Organization: EmblemHealth Inc. Organization Type: PFFS Plan Type: PFFS Name: Jennifer Bauer Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: 175 Scott Swamp Road Legal Entity Address: 175 Scott Swamp Road City: Farmington City: Farmington State: CT State: CT Zip: Zip: Last Updated: 9/30/2007 Legal Entity Name: CONNECTICARE, INC. Contract Number: H3528 Organization Marketing Name: ConnectiCare, Inc. Parent Organization: EmblemHealth Inc. Name: Jennifer Bauer Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 15,227 [email protected] Address: 175 Scott Swamp Road Legal Entity Address: 175 Scott Swamp Road City: Farmington City: Farmington State: CT State: CT Zip: Zip: Last Updated: 9/30/2007 Legal Entity Name: CONNECTICUT GENERAL LIFE INSURANCE COMPANY Contract Number: H2762 Organization Marketing Name: CIGNA Medicare Access Parent Organization: CIGNA Organization Type: PFFS Plan Type: PFFS Name: Doretta Andonucci Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 14,478 [email protected] Address: 900 Cottage Grove Rd Legal Entity Address: 900 Cottage Grove Road City: Hartford Routing B4MKT City: Hartford State: CT State: CT Zip: Zip: Last Updated: 3/26/2009 Legal Entity Name: CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC Contract Number: H4556 Organization Marketing Name: Consolidated Assoc Of Railroad Employees Hc Parent Organization: Consolidated Assoc of Railroad Employees HC Organization Type:HCPP Cost Plan Type:HCPP Cost Contract Effective Date:1/1/1992 Tax Status: CMS Region Responsible:Dallas Enrollment:5,011 Legal Entity Address: 4912 MIDWAY DR. P.O. BOX 6130 City:TEMPLE State:TX Zip:76502 No contact data submitted Name: Phone: Address: City: State: Zip: Last Updated: June 2009 Contract Directory Sorted by Legal Entity Name Page 52 of 190
53 Legal Entity Name: CONTRA COSTA CO MED SVCS DBA CONTRA COSTA HEALTH Contract Number: H5895 Organization Marketing Name: Contra Costa Health Plan Parent Organization: Contra Costa Health Services Director of Marketing and Member Services Name: Teresa O'Riva Contract Effective Date: 1/1/2007 Phone: Tax Status: Not Applicable CMS Region Responsible: San Francisco Enrollment: Address: 595 Center Ave. Ste. 100 Legal Entity Address: 595 Center Ave. Ste. 100 City: Martinez City: Martinez Zip: Zip: Last Updated: 2/27/2007 Legal Entity Name: CONTRA COSTA HEALTH PLAN Contract Number: H0502 Organization Marketing Name: Contra Costa Health Plan Parent Organization: Contra Costa Health Services Organization Type: 1876 Cost Director of Marketing & Member Services Plan Type: 1876 Cost Name: Teresa O'Riva Contract Effective Date: 7/1/1977 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 595 Center Aveune Legal Entity Address: 595 CENTER AVENUE Suite 100 SUITE 100 City: Martinez City: MARTINEZ Zip: Zip: Last Updated: 2/27/2007 Legal Entity Name: COVENTRY HEALTH AND LIFE INS COMPANY Contract Number: H1608 Organization Marketing Name: Coventry Health and Life Insurance Company Parent Organization: Coventry Health Care Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 2,471 Address: 3721 TecPort Dr. Legal Entity Address: th Street City: Harrisburg City: Urbandale State: PA State: IA Zip: Zip: Last Updated: 12/20/2007 Legal Entity Name: COVENTRY HEALTH AND LIFE INS. COMPANY Contract Number: H5509 Organization Marketing Name: Coventry Health And Life Ins. Company Parent Organization: Coventry Health Care Inc. Manager, Medicare Compliance Name: Gail D Howard-King Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 28,160 [email protected] Address: 8320 Ward Parkway Legal Entity Address: 500 Virginia Street, Suite 400 City: Kansas City City: Charleston State: MO State: WV Zip: Zip: Last Updated: 12/3/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 53 of 190
54 Legal Entity Name: COVENTRY HEALTH AND LIFE INS. COMPANY Contract Number: H5517 Organization Marketing Name: Advantra PPO Parent Organization: Coventry Health Care Inc. VP Medicare Compliance Officer Name: Mary Ninos Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 2,356 Address: 6710 Rockledge Dr Legal Entity Address: 6705 Rockledge Drive Bldg B, 5th Fl Suite 900 City: Bethesda City: Bethesda State: MD State: MD Zip: Zip: Last Updated: 2/25/2009 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE CO. (NEBRASKA) Contract Number: H8393 Organization Marketing Name: Coventry Health and Life Insurance Company Parent Organization: Coventry Health Care Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: Address: 3721 TecPort Drive, PO Legal Entity Address: Birch Drive Suite 100 City: Harrisburg City: Omaha State: PA State: NE Zip: Zip: Last Updated: 4/9/2008 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE CO. (SOUTH DAKO Contract Number: H0370 Organization Marketing Name: Coventry Health and Life Insurance Company Parent Organization: Coventry Health Care Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: * no [email protected] Address: 3721 TecPort Dr. Legal Entity Address: th St. City: Harrisburg City: Urbandale State: PA State: IA Zip: Zip: Last Updated: 4/9/2008 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE COMPANY Contract Number: H2947 Organization Marketing Name: Advantra PPO Parent Organization: Coventry Health Care Inc. 1/1/2009 CMS Region Responsible: Denver Enrollment: 260 Director Regulatory Compliance Name: Barbara Sellman Phone: [email protected] Address: 11 Stanwix Street Contract Effective Date: Legal Entity Address: 6705 Rockledge Drive Suite 900 City: Pittsburgh City: Bethesda State: PA State: MD Zip: Zip: Last Updated: 3/11/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 54 of 190
55 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE COMPANY Contract Number: H5227 Organization Marketing Name: Advantra«Freedom Parent Organization: Coventry Health Care Inc. Organization Type: PFFS Customer Service Plan Type: PFFS Name: Advantra Freedom Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Denver Enrollment: 133,256 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: Zip: Last Updated: 2/28/2008 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE COMPANY Contract Number: H8980 Organization Marketing Name: HealthAmerica Advantra Parent Organization: Coventry Health Care Inc. Director, Regulatory Compliance Name: Barbara Sellman Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: Address: 11 Stanwix Street Legal Entity Address: 3721 TecPort Drive Suite 2300 City: Pittsburgh City: Harrisburg State: PA State: PA Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: COVENTRY HEALTH AND LIFE INSURANCE COMPANY Contract Number: H9847 Organization Marketing Name: Coventry Health Care Parent Organization: Coventry Health Care Inc. Org Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: 2,612 Address: 3721 TecPort Drive Legal Entity Address: 6705 Rockledge Drive Suite 900 City: Harrisburg City: Bethesda State: PA State: MD Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: COVENTRY HEALTH CARE OF GEORGIA, INC. Contract Number: H5302 Organization Marketing Name: Advantra Parent Organization: Coventry Health Care Inc. Customer Service Name: Advantra Freedom Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Denver Enrollment: 1,097 Address: 3721 TecPort Dr, PO Legal Entity Address: 1100 Circle 75 Parkway Suite 1400 City: Harrisburg City: Atlanta State: PA State: GA Zip: Zip: Last Updated: 8/24/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 55 of 190
56 Legal Entity Name: COVENTRY HEALTH CARE OF IOWA, INC. Contract Number: H1609 Organization Marketing Name: Coventry Health Care of Iowa, Inc. Parent Organization: Coventry Health Care Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 6,390 Address: 3721 TecPort Dr Legal Entity Address: th Street City: Harrisburg City: Urbandale State: PA State: IA Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: COVENTRY HEALTH CARE OF KANSAS, INC. Contract Number: H2672 Organization Marketing Name: Coventry Health Care of Kansas, Inc. Parent Organization: Coventry Health Care Inc. Manager, Medicare Compliance Name: Gail D Howard-King Contract Effective Date: 5/1/1999 Phone: CMS Region Responsible: Denver Enrollment: 8,036 [email protected] Address: 8320 Ward Parkway Legal Entity Address: 8320 Ward Parkway City: Kansas City City: KANSAS CITY State: MO State: MO Zip: Zip: Last Updated: 3/19/2008 Legal Entity Name: COVENTRY HEALTH CARE OF NEBRASKA, INC. Contract Number: H7149 Organization Marketing Name: Coventry Health Care of Nebraska Advantra Parent Organization: Coventry Health Care Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 1,671 no [email protected] Address: 3721 TecPort Drive, PO Legal Entity Address: Birch Drive Suite 100 City: Harrisburg City: Omaha State: PA State: NE Zip: Zip: Last Updated: 7/3/2007 Legal Entity Name: DAVITA VILLAGEHEALTH INSURANCE OF ALABAMA, INC. Contract Number: H3415 Organization Marketing Name: DaVita VillageHealth Insurance of Alabama, Inc. Parent Organization: Davita Inc Sr Manager, Marketing Operations and Communication Name: Teri Hunt Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway Suite 410 City: Lakewood City: Vernon Hills State: CO State: IL Zip: Zip: Last Updated: 1/14/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 56 of 190
57 Legal Entity Name: DAVITA VILLAGEHEALTH OF DC, INC. Contract Number: H5031 Organization Marketing Name: DaVita VillageHealth of DC, Inc. Parent Organization: Davita Inc Sr Manager, Marketing Operations and Communication Name: Teri Hunt Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 22 Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway Suite 410 City: Lakewood City: Vernon Hills State: CO State: IL Zip: Zip: Last Updated: 1/14/2008 Legal Entity Name: DAVITA VILLAGEHEALTH OF GEORGIA, INC. Contract Number: H6145 Organization Marketing Name: DaVita VillageHealth of Georgia, Inc. Parent Organization: Davita Inc 1/1/2008 Contract Effective Date: Sr Manager, Marketing Operations and Communication Name: Teri Hunt Phone: CMS Region Responsible: Denver Enrollment: Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway Suite 410 City: Vernon Hills IL City: Lakewood State: CO Zip: Last Updated: State: Zip: 1/14/2008 Legal Entity Name: DAVITA VILLAGEHEALTH OF OHIO, INC. Contract Number: H7568 Organization Marketing Name: DaVita VillageHealth of Ohio, Inc. Parent Organization: Davita Inc Sr Manager, Marketing Operations and Communication Name: Teri Hunt Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 49 Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway Suite 410 City: Lakewood City: Vernon Hills State: CO State: IL Zip: Zip: Last Updated: 1/14/2008 Legal Entity Name: DAVITA VILLAGEHEALTH OF VIRGINIA, INC. Contract Number: H5449 Organization Marketing Name: DaVita VillageHealth of Virginia, Inc. Parent Organization: Davita Inc Sr Manager, Marketing Operations and Communication Name: Teri Hunt Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 10 Address: 1627 Cole Blvd Legal Entity Address: Three Hawthorn Parkway Suite 410 City: Lakewood City: Vernon Hills State: CO State: IL Zip: Zip: Last Updated: 1/14/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 57 of 190
58 Legal Entity Name: DEAN HEALTH PLAN, INC. Contract Number: H5264 Organization Marketing Name: Dean Health Plan, Inc. Parent Organization: Dean Health Systems Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Name: Mike Fox Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Chicago Enrollment: 12,583 Address: 1277 Deming Way Legal Entity Address: 1277 DEMING WAY City: Madison City: MADISON State: WI State: WI Zip: Zip: Last Updated: 8/14/2008 Legal Entity Name: DENVER HEALTH MEDICAL PLAN, INC. Contract Number: H5608 Organization Marketing Name: Denver Health Medical Plan Parent Organization: Denver Healthcare Hospital Authority 1/1/2006 Medicare ProgramManager Name: Beth Henchel Phone: Contract Effective Date: CMS Region Responsible: Denver Enrollment: 2,608 Address: 777 Bannock Street Legal Entity Address: 777 Bannock Street Mail Code 6000 mail code 6000 City: Denver City: Denver State: CO State: CO Zip: Zip: Last Updated: 3/24/2009 Legal Entity Name: DESERET HEALTHCARE EMPLOYEE BENEFITS TRUST Contract Number: E5088 Organization Marketing Name: Deseret Mutual Parent Organization: DMBA (Deseret Mutual Benefit Administrators) Organization Type: Employer/Union Only Direct Contract PFFS Plan Type: Employer/Union Only Direct Contract PFFS Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Denver Enrollment: 11,513 Address: 60 East South Temple Legal Entity Address: 60 E. South Temple City: Salt Lake City City: Salt Lake City State: UT State: UT Zip: Zip: Last Updated: 4/12/2007 Legal Entity Name: EASY CHOICE HEALTH PLAN INC. Contract Number: H5087 Organization Marketing Name: Easy Choice Health Plan Parent Organization: Easy Choice Health Plan Inc. Enrollment and Customer Service Department Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: 3,259 Address: S.W. Birch Street Legal Entity Address: S.W. Birch Street Suite 200 Suite 200 City: Newport Beach City: Newport Beach Zip: Zip: Last Updated: 8/25/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 58 of 190
59 Legal Entity Name: EDUCATORS MUTUAL INSURANCE ASSOCIATION Contract Number: H0747 Organization Marketing Name: Educators Mutual Insurance Association Parent Organization: Educators Mutual Insurance Association Organization Type: PFFS Pharmacy Benefits Specialist Plan Type: PFFS Name: Nathan D Gedge Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 1,879 [email protected] Address: 852 East Arrowhead Lane Legal Entity Address: 852 E. Arrowhead Lane City: Murray City: Murray State: UT State: UT Zip: Zip: Last Updated: 1/13/2009 Legal Entity Name: ELDER SERVICE PLAN OF THE NORTH SHORE Contract Number: H2222 Organization Marketing Name: Elder Service Plan of the North Shore Parent Organization: Elder Service Plan of the North Shore Organization Type: National PACE Director Marketing and Enrollment Plan Type: National PACE Name: Linda Leblanc Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: Boston Enrollment: [email protected] Address: 37 Friend Street Legal Entity Address: 37 FRIEND STREET City: Lynn City: LYNN State: MA State: MA Zip: Zip: Last Updated: 8/9/2006 Legal Entity Name: ELDER SRVC PLN/CAMBRIDGE HEALTH ALLIANCE Contract Number: H2221 Organization Marketing Name: Elder Srvc Pln/Cambridge Health Alliance Parent Organization: Cambridge Health Alliance Organization Type: National PACE Plan Type: National PACE Financial Analyst ll Name: Estenieau Jean Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: Boston Enrollment: [email protected] Address: 270 Green Street Legal Entity Address: 270 GREEN STREET City: Cambridge City: CAMBRIDGE State: MA State: MA Zip: Zip: Last Updated: 5/24/2007 Legal Entity Name: ELDER SVC PLN/E BOSTON HEALTH CENTER Contract Number: H2223 Organization Marketing Name: Elder Svc Pln/E Boston Health Center Parent Organization: Elder Svc Pln/E Boston Health Center Organization Type: National PACE Plan Type: National PACE Marketing Director Name: Pamela Pattavina Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: Boston Enrollment: [email protected] Address: 10 Gove St Legal Entity Address: 10 GOVE STREET City: East Boston City: EAST BOSTON State: MA State: MA Zip: Zip: Last Updated: 11/9/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 59 of 190
60 Legal Entity Name: ELDERHAUS INC. Contract Number: H3942 Organization Marketing Name: Elderhaus PACE Parent Organization: Elderhaus Inc. Organization Type: National PACE CFO / PACE PROGRAM DIRECTOR Plan Type: National PACE Name: Larry Reinhart Contract Effective Date: 2/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 24 [email protected] Address: 1950 Amphitheater Dr. Legal Entity Address: 1950 Amphitheater Drive City: Wilmington City: Wilmington State: NC State: NC Zip: Zip: Last Updated: 9/9/2008 Legal Entity Name: ELDERPLAN, INC. Contract Number: H3347 Organization Marketing Name: Elderplan Parent Organization: Elderplan, Inc. 1/1/2006 Contract Effective Date: AVP Sales Admin., Informatics and Customer Service Name: Lois Faust Phone: CMS Region Responsible: New York Enrollment: 1,002 [email protected] Address: 6323 Seventh Avenue Legal Entity Address: 6323 SEVENTH AVENUE City: Brooklyn City: BROOKLYN State: NY State: NY Zip: Zip: Last Updated: 2/14/2008 Legal Entity Name: ELDERPLAN, INC. Contract Number: H8805 Organization Marketing Name: Elderplan, Inc. Parent Organization: Elderplan, Inc. AVP Sales Admin., Informatics and Customer Service Name: Lois Faust Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: 6323 Seventh Avenue Legal Entity Address: 6323 Seventh Avenue City: Brooklyn City: Brooklyn State: NY State: NY Zip: Zip: Last Updated: 2/20/2008 Legal Entity Name: ELDERPLAN, INC. - SHMO Contract Number: H9101 Organization Marketing Name: Elderplan, Inc. Parent Organization: Elderplan, Inc. AVP Sales Admin., Informatics and Customer Service Name: Lois Faust Contract Effective Date: 3/1/1985 Phone: CMS Region Responsible: New York Enrollment: 14,793 [email protected] Address: 6323 Seventh Avenue Legal Entity Address: 6323 SEVENTH AVENUE City: Brooklyn City: BROOKLYN State: NY State: NY Zip: Zip: Last Updated: 3/9/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 60 of 190
61 Legal Entity Name: EMPIRE HEALTHCHOICE ASSURANCE, INC. Contract Number: H3342 Organization Marketing Name: Empire BlueCross BlueShield Parent Organization: Wellpoint, Inc. Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 7,610 Address: P.O. Box 1407 Legal Entity Address: 1 WellPoint Way Church Street Station CAT201-C004 City: New York City: Thousand Oaks State: NY Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: EMPIRE HEALTHCHOICE ASSURANCE, INC. Contract Number: H5304 Organization Marketing Name: Empire BlueCross BlueShield Parent Organization: Wellpoint, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: 3,599 [email protected] Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: EMPIRE HEALTHCHOICE HMO, INC. Contract Number: H3370 Organization Marketing Name: Empire BlueCross BlueShield HMO Parent Organization: Wellpoint, Inc. Contract Effective Date: 7/1/1996 Phone: CMS Region Responsible: Chicago Enrollment: 68,320 [email protected] Address: P.O. Box 1407 Legal Entity Address: 1 WellPoint Way Church Street Station CAT201-C004 City: New York City: Thousand Oaks State: NY Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: ESSENCE HEALTHCARE, INC. Contract Number: H1837 Organization Marketing Name: Essence Healthcare Parent Organization: Essence LLP Director, Claims and Customer Service Name: Dawn Walter Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 5,451 [email protected] Address: Legal Entity Address: Olive Boulevard 4th Floor City: St. Louis City: St. Louis State: MO State: MO Zip: Zip: Last Updated: 1/27/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 61 of 190
62 Legal Entity Name: ESSENCE HEALTHCARE, INC. Contract Number: H2610 Organization Marketing Name: Essence Healthcare Parent Organization: Essence LLP Director, Claims and Customer Service Name: Dawn Walter Contract Effective Date: 6/1/2004 Phone: CMS Region Responsible: Kansas City Enrollment: 19,183 Address: Legal Entity Address: Olive Blvd 4th Floor City: St. Louis City: ST. LOUIS State: MO State: MO Zip: Zip: Last Updated: 1/22/2009 Legal Entity Name: ESSENCE HEALTHCARE, INC. Contract Number: H8778 Organization Marketing Name: Essence Healthcare Parent Organization: Essence LLP Director, Claims and Customer Service Name: Dawn Walter Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 4,411 Address: Legal Entity Address: Olive Boulevard 4th Floor City: St. Louis City: St. Louis State: MO State: MO Zip: Zip: Last Updated: 1/27/2009 Legal Entity Name: EVERCARE OF TEXAS, LLC Contract Number: H4514 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 8/1/2002 Phone: CMS Region Responsible: San Francisco Enrollment: 16,049 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN 008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: EXCELLUS HEALTH PLAN, INC. Contract Number: H3304 Organization Marketing Name: Excellus Health Plan, Inc. Parent Organization: Lifetime Healthcare, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Customer Service Department Name: * Customer Service Contract Effective Date: 9/1/1980 Phone: CMS Region Responsible: New York Enrollment: 61 [email protected] Address: 205 Park Club Lane Legal Entity Address: 205 PARK CLUB LANE City: Buffalo City: WILLIAMSVILLE State: NY State: NY Zip: Zip: Last Updated: 7/9/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 62 of 190
63 Legal Entity Name: EXCELLUS HEALTH PLAN, INC. Contract Number: H3335 Organization Marketing Name: Excellus Health Plan, Inc Parent Organization: Lifetime Healthcare, Inc. Customer Service Department Name: * Customer Service Contract Effective Date: 7/1/2004 Phone: CMS Region Responsible: New York Enrollment: 24,134 [email protected] Address: 205 Park Club Lane Legal Entity Address: 165 Court St. City: Buffalo City: Rochester State: NY State: NY Zip: Zip: Last Updated: 2/12/2007 Legal Entity Name: EXCELLUS HEALTH PLAN, INC. Contract Number: H3351 Organization Marketing Name: Excellus Health Plan, Inc Parent Organization: Lifetime Healthcare, Inc. Customer Service Department Name: * Customer Service Contract Effective Date: 1/1/1990 Phone: CMS Region Responsible: New York Enrollment: 48,771 [email protected] Address: 205 Park Club Lane Legal Entity Address: 205 PARK CLUB LANE City: Buffalo City: Buffalo State: NY State: NY Zip: Zip: Last Updated: 5/20/2008 Legal Entity Name: EXCELLUS HEALTH PLAN, INC. Contract Number: H3356 Organization Marketing Name: Excellus Health Plan, Inc Parent Organization: Lifetime Healthcare, Inc. Organization Type: 1876 Cost Customer Service Department Plan Type: 1876 Cost Name: * Customer Service Contract Effective Date: 1/1/1993 Phone: CMS Region Responsible: New York Enrollment: 3,001 [email protected] Address: 205 Park Club Lane Legal Entity Address: 165 COURT STREET City: Buffalo City: ROCHESTER State: NY State: NY Zip: Zip: Last Updated: 11/20/2008 Legal Entity Name: FALLON COMMUNITY HEALTH PLAN Contract Number: H2219 Organization Marketing Name: Fallon Community Health Plan - Summit ElderCare Parent Organization: Fallon Community Health Plan Organization Type: National PACE Plan Type: National PACE Director of Operations, Summit ElderCare Name: Anne Peepas, RN Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: Boston Enrollment: [email protected] Address: Two Chestnut Place Legal Entity Address: 10 CHESTNUT STREET 10 Chestnut Street City: Worcester City: WORCESTER State: MA State: MA Zip: Zip: Last Updated: 5/7/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 63 of 190
64 Legal Entity Name: FALLON COMMUNITY HEALTH PLAN Contract Number: H2411 Organization Marketing Name: Fallon Community Health Plan Parent Organization: Fallon Community Health Plan Sr. Manager Medicare Programs Name: Lisa Lashbrook Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Boston Enrollment: Address: One Chestnut Place Legal Entity Address: 10 CHESTNUT STREET 10 Chestnut Street City: Worcester City: WORCESTER State: MA State: MA Zip: Zip: Last Updated: 5/5/2009 Legal Entity Name: FALLON COMMUNITY HEALTH PLAN Contract Number: H9001 Organization Marketing Name: Fallon Community Health Plan Parent Organization: Fallon Community Health Plan 4/1/1980 Not-for-Profit/Non-Profit CMS Region Responsible: Boston Enrollment: 29,636 Sr. Manager Medicare Programs Name: Lisa Lashbrook Phone: Address: One Chestnut Place Contract Effective Date: Tax Status: Legal Entity Address: ONE CHESTNUT PLACE 10 Chestnut Street 10 CHESTNUT STREET City: Worcester City: WORCESTER State: MA State: MA Zip: Zip: Last Updated: 5/5/2009 Legal Entity Name: FAMILYCARE HEALTH PLANS, INC. Contract Number: H3818 Organization Marketing Name: FamilyCare Health Plans, Inc. Parent Organization: FamilyCare Incorporated Marketing Program Specialist Name: Miguel Villarreal Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 2,327 Address: 825 NE Multnomah, Suite 300 Legal Entity Address: 825 NE MULTNOMAH, SUITE 300 City: Portland City: PORTLAND State: OR State: OR Zip: Zip: Last Updated: 12/11/2008 Legal Entity Name: FIDELIS SECURECARE OF MICHIGAN Contract Number: H2323 Organization Marketing Name: Fidelis SecureCare Of Michigan Parent Organization: Fidelis SecureCare Manager - Customer Services-Production Name: Ronald Rome Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 201 Lackawanna Ave Legal Entity Address: WEST SIX MILE ROAD Suite 207 City: Scranton City: LIVONIA State: PA State: MI Zip: Zip: Last Updated: 3/13/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 64 of 190
65 Legal Entity Name: FIDELIS SECURECARE OF NORTH CAROLINA Contract Number: H5575 Organization Marketing Name: Fidelis SecureCare of North Carolina Parent Organization: Fidelis SecureCare Manager - Customer Services-Production Name: Ron Rome Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 201 Lackawanna Avenue Legal Entity Address: 9300 Harris Corners Parkway Suite 100 City: Scranton City: Charlotte State: PA State: NC Zip: Zip: Last Updated: 3/13/2009 Legal Entity Name: FIDELIS SECURECARE OF TEXAS, INC. Contract Number: H5980 Organization Marketing Name: Fidelis SecureCare of Texas, Inc. Parent Organization: Fidelis SecureCare Manager - Customer Services-Production Name: Ron Rome Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 201 Lackawanna Avenue Legal Entity Address: El Camino Real Suite 210 City: Scranton City: Houston State: PA State: TX Zip: Zip: Last Updated: 3/13/2009 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE CO Contract Number: H7206 Organization Marketing Name: Advantra«Savings Parent Organization: Coventry Health Care Inc. Organization Type: MSA Plan Type: MSA Customer Service Name: Advantra Savings Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 2,988 [email protected] Address: P.O Box 7154 Legal Entity Address: 6705 ROCKLEDGE DRIVE SUITE 900 City: London City: BETHESDA State: KY State: MD Zip: Zip: Last Updated: 2/11/2008 Legal Entity Name: FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY Contract Number: H7306 Organization Marketing Name: Coventry Advantra Parent Organization: Coventry Health Care Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: 1,026 no [email protected] Address: 3721 TecProt Dr Legal Entity Address: 6705 Rockledge Drive Suite 900 City: Harrisburg City: Bethesda State: PA State: MD Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 65 of 190
66 Legal Entity Name: FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY Contract Number: H8239 Organization Marketing Name: Coventry Advantra Parent Organization: Coventry Health Care Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: 90 Address: 3721 TecPort Dr Legal Entity Address: 6710 Rockledge Drive City: Harrisburg City: Bethesda State: PA State: MD Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Contract Number: H0846 Organization Marketing Name: Advantra«Freedom Parent Organization: Coventry Health Care Inc. Organization Type: PFFS Customer Service Plan Type: PFFS Name: Advantra Freedom Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Denver Enrollment: 188,894 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: Zip: Last Updated: 2/28/2008 Legal Entity Name: FIRST HEALTH LIFE AND HEALTH INSURANCE COMPANY Contract Number: H7692 Organization Marketing Name: Coventry Advantra Parent Organization: Coventry Health Care Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: Address: 3721 TecPort Dr Legal Entity Address: 6705 Rockledge Drive Suite 900 City: Harrisburg City: Bethesda State: PA State: MD Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: FIRST MEDICAL HEALTH PLAN (OF FLORIDA) Contract Number: H3214 Organization Marketing Name: First Medical Health Plan of Florida, Inc. Parent Organization: First Medical Health Plan of Florida, Inc. IT Manager Name: Carlos Santana Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: Address: PO Box Legal Entity Address: P.O. Box City: Miami City: Miami State: FL State: FL Zip: Zip: Last Updated: 9/20/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 66 of 190
67 Legal Entity Name: FIRST MEDICAL HEALTH PLAN, INC. Contract Number: H4011 Organization Marketing Name: First Medical Health Plan, Inc. Parent Organization: First Medical Health Plan Compliance Officer Name: Alejandra Echevarria Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: New York Enrollment: 10,319 Address: P.O. Box Legal Entity Address: PO BOX City: San Juan City: SAN JUAN State: PR State: PR Zip: Zip: Last Updated: 4/5/2009 Legal Entity Name: FIRST MEDICAL HEALTH PLAN, INC. Contract Number: H5887 Organization Marketing Name: First Medical Health Plan, Inc. Parent Organization: First Medical Health Plan Compliance Officer Name: Alejandra Echevarria Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 1,482 Address: P.O. Box Legal Entity Address: P.O. Box City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 4/6/2009 Legal Entity Name: FIRST PLAN OF MINNESOTA Contract Number: H2424 Organization Marketing Name: FirstPlan Blue Parent Organization: Blue Cross and Blue Shield of Minnesota Marketing/Communications Manager Name: Gardner Lepp Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 1,053 Address: 525 S Lake Avenue Legal Entity Address: 525 S. LAKE AVE, SUITE 222 Suite 222 City: Duluth City: DULUTH State: MN State: MN Zip: Zip: Last Updated: 4/17/2007 Legal Entity Name: FIRSTSOLUTIONS DBA FIRST PLAN OF MINNESOTA Contract Number: H9951 Organization Marketing Name: FirstPlan Blue Parent Organization: Blue Cross and Blue Shield of Minnesota Marketing/Communications Manager Name: Gardner Lepp Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 51 [email protected] Address: 525 S Lake Avenue Legal Entity Address: 525 S. Lake Suite 222 Suite 222 City: Duluth City: Duluth State: MN State: MN Zip: Zip: Last Updated: 5/2/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 67 of 190
68 Legal Entity Name: FLORIDA HEALTH CARE PLAN, INC. Contract Number: H1035 Organization Marketing Name: Florida Health Care Plan, Inc. Parent Organization: Blue Cross and Blue Shield of Florida Manager of Goverment Contracts Name: Christine Bartlett Contract Effective Date: 11/1/1985 Phone: CMS Region Responsible: Atlanta Enrollment: 14,243 Address: 1340 Ridgewood Avenue Legal Entity Address: 1340 Ridgewood Avenue City: Holly Hill City: Holly Hill State: FL State: FL Zip: Zip: Last Updated: 4/13/2007 Legal Entity Name: FLORIDA PACE CENTERS, INC. Contract Number: H1043 Organization Marketing Name: Florida Pace Centers, Inc. Parent Organization: Florida PACE Centers, Inc. Organization Type: National PACE Plan Type: National PACE 1/1/2003 Program Director Name: Karen Wells Phone: Contract Effective Date: CMS Region Responsible: Atlanta Enrollment: Address: 5200 NE 2nd Avenue Legal Entity Address: MIAMI JEWISH HOME/HOSP. FOR AGED 5200 NORTHEAST SECOND AVENUE City: Miami City: MIAMI State: FL State: FL Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: FRANCISCAN PACE, INC. Contract Number: H6231 Organization Marketing Name: PACE Baton Rouge Parent Organization: Franciscan PACE, Inc. Organization Type: National PACE Plan Type: National PACE Executive Director Name: Karen Allen Contract Effective Date: 7/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 44 Address: 7436 Bishop Ott Drive Legal Entity Address: 7436 Bishop Ott Drive City: Baton Rouge City: Baton Rouge State: LA State: LA Zip: Zip: Last Updated: 3/13/2009 Legal Entity Name: FREEDOM HEALTH PLAN, INC. Contract Number: H5427 Organization Marketing Name: Freedom Health, Inc. Parent Organization: Freedom Health, Inc Sr. VP Operations Name: Chris O'Connor Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 32,475 Address: 5403, Church Ave N, Legal Entity Address: 5403 N Church Avenue City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 1/12/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 68 of 190
69 Legal Entity Name: GATEWAY HEALTH PLAN OF OHIO, INC. Contract Number: H8031 Organization Marketing Name: Gateway Health Plan Medicare Assured Parent Organization: Gateway Health Plan Name: Gateway Health Plan Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: 67 Address: 600 Grant Street, 41st Floor Legal Entity Address: 600 Grant Street- 41st Floor City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 8/18/2006 Legal Entity Name: GATEWAY HEALTH PLAN, INC. Contract Number: H5932 Organization Marketing Name: Gateway Health Plan Medicare Assured Parent Organization: Gateway Health Plan Name: Gateway Health Plan Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Philadelphia Enrollment: 24,726 Address: 600 Grant Street, 41st Floor Legal Entity Address: 600 Grant Street - 41st Floor City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 12/11/2007 Legal Entity Name: GEISINGER COMMUNITY HEALTH SERVICES Contract Number: H2064 Organization Marketing Name: LIFE Geisinger Parent Organization: Geisinger Health System Organization Type: National PACE Plan Type: National PACE Director, LIFE Geisinger Name: Amy L Minnich Contract Effective Date: 6/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: 100 North Academy Avenue Legal Entity Address: 100 North Academy Avenue MC 6065 MC City: Danville City: Danville State: PA State: PA Zip: Zip: Last Updated: 5/14/2008 Legal Entity Name: GEISINGER HEALTH PLAN Contract Number: H3954 Organization Marketing Name: Geisinger Gold Parent Organization: Geisinger Health System Director of Customer Service Name: Renee Blasi Contract Effective Date: 3/1/1994 Phone: CMS Region Responsible: Philadelphia Enrollment: 35,081 [email protected] Address: 100 North Academy Avenue Legal Entity Address: 100 NORTH ACADEMY AVENUE City: Danville City: DANVILLE State: PA State: PA Zip: Zip: Last Updated: 12/14/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 69 of 190
70 Legal Entity Name: GEISINGER INDEMNITY INSURANCE COMPANY Contract Number: H3924 Organization Marketing Name: Geisinger Gold Parent Organization: Geisinger Health System Director of Customer Service Name: Renee Blasi Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: 1,247 Address: 100 North Academy Avenue Legal Entity Address: 100 NORTH ACADEMY AVE. City: Danville City: DANVILLE State: PA State: PA Zip: Zip: Last Updated: 11/11/2007 Legal Entity Name: GEISINGER INDEMNITY INSURANCE COMPANY Contract Number: H5812 Organization Marketing Name: Geisinger Gold Parent Organization: Geisinger Health System Organization Type: PFFS Plan Type: PFFS 1/1/2006 For Profit Director of Customer Service Name: Renee Blasi Phone: Contract Effective Date: Tax Status: CMS Region Responsible: Philadelphia Enrollment: 1,615 Address: 100 North Academy Avenue Legal Entity Address: 100 North Academy Avenue City: Danville City: Danville State: PA State: PA Zip: Zip: Last Updated: 11/11/2007 Legal Entity Name: GEISINGER INDEMNITY INSURANCE COMPANY Contract Number: H8468 Organization Marketing Name: Geisinger Gold Parent Organization: Geisinger Health System Organization Type: MSA Plan Type: MSA Director of Customer Service Name: Renee Blasi Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: Address: 100 North Academy Avenue Legal Entity Address: 100 North Academy Avenue City: Danville City: Danville State: PA State: PA Zip: Zip: Last Updated: 12/14/2007 Legal Entity Name: GEMCARE HEALTH PLAN INC. Contract Number: H5609 Organization Marketing Name: GEMCARE Health Plan Parent Organization: Golden Empire Managed Care Marketing Manager Name: Ana Igoa Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 6,376 Address: 4550 California Avenue Legal Entity Address: 4550 California Avenue Suite 100 Suite 100 City: Bakersfield City: Bakersfield Zip: Zip: Last Updated: 10/10/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 70 of 190
71 Legal Entity Name: GLOBALHEALTH, INC. Contract Number: H3706 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Service Representative Name: Member Services Contract Effective Date: 1/1/2004 Phone: CMS Region Responsible: Dallas Enrollment: 7,828 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: Zip: Last Updated: 12/9/2008 Legal Entity Name: GREAT LAKES HEALTH PLAN, INC. Contract Number: H6952 Organization Marketing Name: Great Lakes Personal Care Plus Provider Services Name: Dawnyalle Gillis Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: Address: W. Nine Mile Rd. Ste 1600 Legal Entity Address: W. Nine Mile Road Suite 1600 City: Southfield City: Southfield State: MI State: MI Zip: Zip: Last Updated: 11/20/2008 Legal Entity Name: GROUP HEALTH COOPERATIVE Contract Number: H5050 Organization Marketing Name: Group Health Cooperative Parent Organization: Group Health Cooperative Health Plan Operations Name: Provider Assistance Unit Contract Effective Date: 1/1/1989 Phone: CMS Region Responsible: Seattle Enrollment: 55,458 Address: Group Health Cooperative, Provider Assistance Unit Legal Entity Address: 320 Westlake Avenue North, Suite 100 PO Box Attn: Medicare Programs & Compliance City: Seattle City: SEATTLE State: WA State: WA Zip: Zip: Last Updated: 6/2/2008 Legal Entity Name: GROUP HEALTH INC, Contract Number: H2462 Organization Marketing Name: HealthPartners Freedom Plan Parent Organization: HealthPartners, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Name: Provider Services Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Chicago Enrollment: 35,952 Address: rd Avenue South Legal Entity Address: rd Avenue South PO Box 1309 PO Box 1309 City: Minneapolis City: MINNEAPOLIS State: MN State: MN Zip: Zip: Last Updated: 4/24/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 71 of 190
72 Legal Entity Name: GROUP HEALTH INCORPORATED Contract Number: H5528 Organization Marketing Name: GHI Medicare PPO Parent Organization: EmblemHealth Inc. Manager Medicare Programs Name: Peggy Fry Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 20,232 Address: 80 Wolf Road Legal Entity Address: 80 Wolf Road 6th Floor 6th Floor City: Albany City: Albany State: NY State: NY Zip: Zip: Last Updated: 2/18/2009 Legal Entity Name: GROUP HEALTH PLAN, INC. Contract Number: H2663 Organization Marketing Name: Group Health Plan, Inc. Parent Organization: Coventry Health Care Inc. 11/1/1995 CMS Region Responsible: Denver Enrollment: 27,870 Medicare Marketing Department Name: GHP Medicare Marketing D Phone: no @cvty.com Address: 550 Maryville Centre Drive Contract Effective Date: Legal Entity Address: 550 Maryville Centre Drive Suite 300 Suite 300 City: St. Louis City: St. Louis State: MO State: MO Zip: Zip: Last Updated: 8/15/2007 Legal Entity Name: GROUP HOSPITALIZATION AND MEDICAL SERVICES, INC. Contract Number: H2788 Organization Marketing Name: Medi-CareFirst BlueCross BlueShield Parent Organization: CareFirst, Inc. Organization Type: PFFS Plan Type: PFFS Director, Pharmacy Management Name: Winston Wong Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: 66 [email protected] Address: 1501 S. Clinton St 8th Floor Legal Entity Address: 840 First Street NE Attn: Jordana Bradley City: Baltimore City: Washington State: MD State: DC Zip: Zip: Last Updated: 5/15/2008 Legal Entity Name: GUARDIAN HEALTHCARE,INC. Contract Number: H4917 Organization Marketing Name: Guardian Healthcare, Inc. Parent Organization: Guardian Healthcare, Inc. Organization Type: PFFS COO and Compliance Officer Plan Type: PFFS Name: Richard E Cairl Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Atlanta Enrollment: 1,113 [email protected] Address: 33 Market Point Drive Legal Entity Address: 33 Market Point Drive City: Greenville City: Greenville State: SC State: SC Zip: Zip: Last Updated: 1/23/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 72 of 190
73 Legal Entity Name: GUILDNET, INC. Contract Number: H6864 Organization Marketing Name: GuildNet Parent Organization: Guildnet, Inc. Contract Effective Date: 1/1/2008 CMS Region Responsible: New York Enrollment: 145 Legal Entity Address: 15 WEST 65TH STREET City: NEW YORK State: NY Zip: Legal Entity Name: GUNDERSEN LUTHERAN HEALTH PLAN Contract Number: H5262 Organization Marketing Name: Gundersen Lutheran Health Plan, Inc. Parent Organization: Gunderson Lutheran, Inc. Contract Effective Date: 8/1/1999 CMS Region Responsible: Chicago Enrollment: 11,112 Legal Entity Address: 3190 Gundersen Drive City: Onalaska State: WI Zip: Legal Entity Name: HALE MAKUA Contract Number: H5324 Organization Marketing Name: Maui PACE Parent Organization: HALE MAKUA Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 10/1/2008 CMS Region Responsible: San Francisco Enrollment: 10 Legal Entity Address: 472 Kaulana Street City: Kahului, Maui State: HI Zip: Legal Entity Name: HARBOR HEALTH SERVICES Contract Number: H2218 Organization Marketing Name: Elder Service Plan of Harbor Health Services, Inc Parent Organization: Harbor Health Services, Inc. Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 11/1/2002 CMS Region Responsible: Boston Enrollment: 295 Legal Entity Address: 2216 DORCHESTER AVE City: DORCHESTER State: MA Zip: VP, Medicare Services Name: Toni Cassetta Phone: Address: 15 West 65th Street City: New York State: NY Zip: Last Updated: 7/8/2008 Phone: Address: 1900 South Avenue Mailstop: NCA2-01 City: La Crosse State: WI Zip: Last Updated: 8/21/2006 Director Name: Connie Miller Phone: Address: 472 Kaulana Street City: Kahului State: HI Zip: Last Updated: 9/8/2008 Community Outreach Manager Name: Lisa Yorra Phone: Address: 2216 Dorchester Ave City: Dorchester State: MA Zip: Last Updated: 10/30/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 73 of 190
74 Legal Entity Name: HARMONY HEALTH PLAN OF ILLINOIS, INC. Contract Number: H1216 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 1,375 Address: 8735 Henderson Road Legal Entity Address: 23 Public Square Suite 400 City: Tampa City: Belleville State: FL State: IL Zip: Zip: Last Updated: 1/11/2009 Legal Entity Name: HARMONY HEALTH PLAN OF ILLINOIS, INC. Contract Number: H1416 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. 5/1/2005 For Profit CMS Region Responsible: Atlanta Enrollment: 13,304 Plan Directory Contact Name: Mary Solomon Phone: Address: 8735 Henderson Road Contract Effective Date: Tax Status: 3091 Legal Entity Address: 125 SOUTH WACKER DRIVE SUITE 2600 City: Tampa City: CHICAGO State: FL State: IL Zip: Zip: Last Updated: 1/12/2009 Legal Entity Name: HARMONY HEALTH PLANS OF ILLINOIS, INC. Contract Number: H1657 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 2,021 Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd., Ren 2 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 1/12/2009 Legal Entity Name: HARVARD PILGRIM HEALTH CARE INC. Contract Number: H7226 Organization Marketing Name: HARVARD PILGRIM HEALTH CARE INC. Parent Organization: Harvard Pilgrim Health Care Organization Type:PFFS Plan Type:PFFS Contract Effective Date:1/1/2007 Tax Status:Not-for-Profit/Non-Profit CMS Region Responsible:Boston Enrollment:27,172 Legal Entity Address: 93 Wocester Street City:Wellesley State:MA Zip:02481 Medicare Compliance Officer Name:Michael J Comerford Phone: [email protected] Address:1600 Crown Colony Drive City:Quincy State:MA Zip:02169 Last Updated:4/28/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 74 of 190
75 Legal Entity Name: HAWAII MEDICAL SERVICE ASSOCIATION (HMSA) Contract Number: H1251 Organization Marketing Name: HMSA's 65C Plus Parent Organization: Hawaii Medical Service Association Organization Type: 1876 Cost Plan Type: 1876 Cost Manager Name: Kevin Unger Contract Effective Date: 1/1/1998 Phone: CMS Region Responsible: San Francisco Enrollment: 36,658 Address: CR Legal Entity Address: 10 - GA 818 Keeaumoku St 818 Keeaumoku St City: Honolulu City: Honolulu State: HI State: HI Zip: Zip: Last Updated: 2/7/2009 Legal Entity Name: HCSC INSURANCE SERVICES COMPANY Contract Number: H3208 Organization Marketing Name: HISC - Blue Cross Blue Shield of New Mexico Parent Organization: Health Care Service Corporation Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 2,584 [email protected] Address: P.O. Box 3567 Legal Entity Address: 901 South Central Expressway, North Building City: Scranton City: Richardson State: PA State: TX Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HCSC INSURANCE SERVICES COMPANY Contract Number: H3709 Organization Marketing Name: HISC - Blue Cross And Blue Shield Of Oklahoma Parent Organization: Health Care Service Corporation Director of Customer Service Name: Pat Hall Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 1,877 [email protected] Address: 218 W 6th Street Legal Entity Address: 901 South Central Expressway, North Building City: Tulsa City: Richardson State: OK State: TX Zip: Zip: Last Updated: 9/1/2006 Legal Entity Name: HCSC INSURANCE SERVICES COMPANY Contract Number: H4531 Organization Marketing Name: HISC - Blue Cross Blue Shield of Texas Parent Organization: Health Care Service Corporation Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: [email protected] Address: P.O. Box 3567 Legal Entity Address: 901 South Central Expressway, North Building City: Scranton City: Richardson State: PA State: TX Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 75 of 190
76 Legal Entity Name: HCSC INSURANCE SERVICES COMPANY Contract Number: H6013 Organization Marketing Name: HISC - Blue Cross Blue Shield of IL, NM, OK & TX Parent Organization: Health Care Service Corporation Organization Type: PFFS Plan Type: PFFS Name: Brenda Hightower Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: * [email protected] Address: Blue Cross Blue Shield of Texas Legal Entity Address: 901 South Central Expressway, North Building City: Richardson State: TX Zip: Last Updated: 3/6/2007 Legal Entity Name: HEALTH ALLIANCE MEDICAL PLANS Contract Number: H0087 Organization Marketing Name: Health Alliance Medical Plans Parent Organization: Health Alliance Medical Plans Organization Type: PFFS Plan Type: PFFS 1/1/ S. Central Expressway City: Richardson State: TX Zip: Medicare Services Manager Name: Jennifer Marquardt Phone: Contract Effective Date: CMS Region Responsible: Chicago Enrollment: 20 [email protected] Address: 301 S. Vine St. Legal Entity Address: 301 S. Vine St. City: Urbana City: Urbana State: IL State: IL Zip: Zip: Last Updated: 2/29/2008 Legal Entity Name: HEALTH ALLIANCE MEDICAL PLANS Contract Number: H1417 Organization Marketing Name: Health Alliance Medical Plans Parent Organization: Health Alliance Medical Plans Medicare Services Manager Name: Jennifer Marquardt Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 3,342 [email protected] Address: 301 S. Vine St. Legal Entity Address: 301 S Vine St PO Box 6003 City: Urbana City: URBANA State: IL State: IL Zip: Zip: Last Updated: 2/29/2008 Legal Entity Name: HEALTH ALLIANCE MEDICAL PLANS Contract Number: H1463 Organization Marketing Name: Health Alliance Medical Plans Parent Organization: Health Alliance Medical Plans Medicare Services Manager Name: Jennifer Marquardt Contract Effective Date: 10/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: 6,401 [email protected] Address: 301 S. Vine St. Legal Entity Address: 301 S Vine St PO Box 6003 City: Urbana City: URBANA State: IL State: IL Zip: Zip: Last Updated: 2/29/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 76 of 190
77 Legal Entity Name: HEALTH ALLIANCE PLAN OF MICHIGAN Contract Number: H2312 Organization Marketing Name: HAP Senior Plus Parent Organization: Health Alliance Plan (HAP) Coach/Manager Tech Planning Name: Cindy Hoffman Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: Chicago Enrollment: 30,687 Address: 2850 W. Grand Blvd. Legal Entity Address: 2850 W. GRAND BLVD. City: Detroit City: DETROIT State: MI State: MI Zip: Zip: Last Updated: 8/17/2006 Legal Entity Name: HEALTH CHOICE ARIZONA, INC. Contract Number: H5587 Organization Marketing Name: Health Choice Generations Parent Organization: IASIS Healthcare 1/1/2006 Plan Directory Contact for Public Website Phone: Contract Effective Date: CMS Region Responsible: San Francisco Enrollment: 3,484 Address: 410 N 44th Street, Suite 510 Legal Entity Address: 410 N 44th Street Suite 510 City: Phoenix AZ City: Phoenix State: AZ Zip: Last Updated: State: Zip: 4/23/2009 Legal Entity Name: HEALTH FIRST HEALTH PLANS, INC. Contract Number: H1099 Organization Marketing Name: Health First Medicare Plans Parent Organization: Health First Contract Effective Date: 4/1/1997 Phone: CMS Region Responsible: Atlanta Enrollment: 22,836 [email protected] Address: 6450 US Highway 1 Legal Entity Address: 6450 US HIGHWAY 1 City: Rockledge City: ROCKLEDGE State: FL State: FL Zip: Zip: Last Updated: 9/11/2006 Legal Entity Name: HEALTH NET INSURANCE OF NEW YORK, INC. Contract Number: H5721 Organization Marketing Name: Health Net Pearl Parent Organization: Health Net, Inc. Organization Type: PFFS Plan Type: PFFS Provider and Provider Directory Information Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Seattle Enrollment: 2,085 [email protected] Address: 2019 Aerojet Rd., Mail Stop: CA Legal Entity Address: 399 Knollwood Road, Suite 113 City: Rancho Cordova City: White Plains State: NY Zip: Zip: Last Updated: 3/14/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 77 of 190
78 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY Contract Number: H5439 Organization Marketing Name: Health Net Life Insurance Company Parent Organization: Health Net, Inc. Provider and Provider Directory Information Name: Member Services Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: Address: P.O. Box Legal Entity Address: BURBANK BLVD. Building B City: Van Nuys City: WOODLAND HILLS Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY Contract Number: H5520 Organization Marketing Name: Health Net Medicare Advantage Parent Organization: Health Net, Inc. Provider and Provider Directory Information Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Seattle Enrollment: 23,262 [email protected] Address: SW 68th Parkway Legal Entity Address: SW 68th Parkway, Ste. 200 City: Tigard City: Tigard State: OR State: OR Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY Contract Number: R5863 Organization Marketing Name: Health Net Parent Organization: Health Net, Inc. Organization Type: Regional CCP Provider and Provider Directory Information Plan Type: Regional PPO Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Seattle Enrollment: 4,249 [email protected] Address: P.O. Box 881 Legal Entity Address: 1230 West Washington St. Suite 401 City: Shelton City: Tempe State: CT State: AZ Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: HEALTH NET LIFE INSURANCE COMPANY, INC. Contract Number: H5996 Organization Marketing Name: Health Net Pearl Parent Organization: Health Net, Inc. Organization Type: PFFS Plan Type: PFFS Provider and Provider Directory Information Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Seattle Enrollment: 12,838 [email protected] Address: 2019 Aerojet Rd., Mail Stop: CA Legal Entity Address: Oxnard St City: Rancho Cordova City: Woodland Hills Zip: Zip: Last Updated: 3/14/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 78 of 190
79 Legal Entity Name: HEALTH NET OF ARIZONA, INC. Contract Number: H0351 Organization Marketing Name: Health Net of Arizona, Inc. Parent Organization: Health Net, Inc. Provider and Provider Directory Information Name: Member Services Contract Effective Date: 3/1/1992 Phone: CMS Region Responsible: Seattle Enrollment: 60,483 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: Zip: Last Updated: 8/23/2006 Legal Entity Name: HEALTH NET OF CONNECTICUT Contract Number: H0755 Organization Marketing Name: Health Net of Connecticut Parent Organization: Health Net, Inc. Provider and Provider Directory Information Name: Member Services Contract Effective Date: 12/1/1996 Phone: CMS Region Responsible: Seattle Enrollment: 52,473 Address: One Far Mill Crossing Legal Entity Address: ONE FAR MILL CROSSING City: Shelton City: SHELTON State: CT State: CT Zip: Zip: Last Updated: 8/29/2006 Legal Entity Name: HEALTH NET_OF CA Contract Number: H0562 Organization Marketing Name: Health Net of CA Parent Organization: Health Net, Inc. Provider and Provider Directory Information Name: Member Services Contract Effective Date: 10/1/1992 Phone: CMS Region Responsible: Seattle Enrollment: 126,824 Address: P.O. Box Legal Entity Address: BURBANK BLVD. BUILDING B City: Van Nuys City: WOODLAND HILLS Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: HEALTH NEW ENGLAND, INC. Contract Number: H8578 Organization Marketing Name: Health New England, Inc. Parent Organization: Baystate Health, Inc. Communications Manager Name: Joseph Kane Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Boston Enrollment: [email protected] Address: Health New England, Inc. Legal Entity Address: One Monarch Place One Monarch Place, Suite 1500 Suite 1500 City: Springfield City: Springfield State: MA State: MA Zip: Zip: Last Updated: 2/14/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 79 of 190
80 Legal Entity Name: HEALTH OPTIONS, INC Contract Number: H1026 Organization Marketing Name: Health Options, Inc / Blue Cross Blue Shield of FL Parent Organization: Blue Cross and Blue Shield of Florida Manager B - Contact SFl Name: Martha Garcia Contract Effective Date: 8/1/1986 Phone: CMS Region Responsible: Atlanta Enrollment: 23,410 [email protected] Address: 8400 NW 33rd St Legal Entity Address: 4800 Deerwood Campus Parkway Suite 100 City: Miami City: Jacksonville State: FL State: FL Zip: Zip: Last Updated: 4/1/2009 Legal Entity Name: HEALTH PLAN OF CAREOREGON, INC. Contract Number: H5859 Organization Marketing Name: CareOregon Advantage Parent Organization: CareOregon, Inc. 1/1/2006 Member Services Supervisor Name: David Lima Phone: Contract Effective Date: CMS Region Responsible: Seattle Enrollment: 5,363 [email protected] Address: CareOregon Advantage Legal Entity Address: 315 SW Fifth Ave. Suite SW Fifth Avenue, Suite 900 City: Portland City: Portland State: OR State: OR Zip: Zip: Last Updated: 5/1/2007 Legal Entity Name: HEALTH PLAN OF NEVADA, INC. Contract Number: H2931 Organization Marketing Name: Health Plan of Nevada, Inc. Network Contract Coordinator Name: David Gardineer Contract Effective Date: 6/1/1985 Phone: CMS Region Responsible: San Francisco Enrollment: 1,038 [email protected] Address: P.O. Box Legal Entity Address: 2720 NORTH TENAYA WAY P.O. BOX City: Las Vegas City: LAS VEGAS State: NV State: NV Zip: Zip: Last Updated: 3/10/2009 Legal Entity Name: HEALTH PLAN OF NEVADA, INC. Contract Number: H2961 Organization Marketing Name: Health Plan of Nevada, Inc. Director, Government Programs/Member Services Name: David Stuczynski Contract Effective Date: 10/1/1996 Phone: CMS Region Responsible: San Francisco Enrollment: 55,329 [email protected] Address: 2716 N. Tenaya Way Legal Entity Address: 2720 N. TENAYA WAY City: Las Vegas City: LAS VEGAS State: NV State: NV Zip: Zip: Last Updated: 6/12/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 80 of 190
81 Legal Entity Name: HEALTH PLAN OF THE UPPER OHIO VALLEY Contract Number: H5151 Organization Marketing Name: The Health Plan Parent Organization: Health Plan of the Upper Ohio Valley Director Member Services Name: Sherry Stanley Contract Effective Date: 2/1/1999 Phone: CMS Region Responsible: Philadelphia Enrollment: 9,833 Address: The Health Plan Legal Entity Address: NATIONAL ROAD EAST City: ST. CLAIRSVILLE State: OH National Road East City: St. Clairsville State: OH Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: HEALTHAMERICA PENNSYLVANIA, INC. Contract Number: H3959 Organization Marketing Name: HealthAmerica Advantra Parent Organization: Coventry Health Care Inc. Director, Regulatory Compliance Name: Barbara Sellman Contract Effective Date: 1/1/1996 Phone: CMS Region Responsible: Denver Enrollment: 37,641 Address: 11 Stanwix Street Legal Entity Address: 11 Stanwix Street Suite 2300 City: Pittsburgh City: PITTSBURGH State: PA State: PA Zip: Zip: Last Updated: 12/5/2007 Legal Entity Name: HEALTHASSURANCE PENNSYLVANIA, INC. Contract Number: H5522 Organization Marketing Name: HealthAmerica Advantra Parent Organization: Coventry Health Care Inc. Director, Regulatory Compliance Name: Barbara Sellman Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 17,156 Address: 11 Stanwix Street Legal Entity Address: 11 Stanwix Street Suite 2300 City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 12/5/2007 Legal Entity Name: HEALTHFIRST HEALTH PLAN OF NEW JERSEY, INC. Contract Number: H7015 Organization Marketing Name: Healthfirst NJ Parent Organization: Healthfirst Management Services, LLC. Healthfirst Medicare Plan Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 2,855 Address: 25 Broadway Legal Entity Address: 25 Broadway 9th Floor 9th Floor City: New York City: New York State: NY State: NY Zip: Zip: Last Updated: 4/9/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 81 of 190
82 Legal Entity Name: HEALTHNOW NEW YORK INC Contract Number: H3384 Organization Marketing Name: Senior Blue Parent Organization: HealthNow New York Inc. Division Mgr, Commercial Gov't Programs Name: Linda Warren Contract Effective Date: 2/1/1998 Phone: CMS Region Responsible: New York Enrollment: 35,910 Address: 30 Century Hill Drive Legal Entity Address: 257 West Genesee Street City: Latham City: BUFFALO State: NY State: NY Zip: Zip: Last Updated: 12/3/2007 Legal Entity Name: HEALTHNOW NEW YORK INC. Contract Number: H5526 Organization Marketing Name: Forever Blue Medicare PPO Parent Organization: HealthNow New York Inc. Division Mgr, Commercial Gov't Programs Name: Linda Warren Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 18,814 Address: 30 Century Hill Drive Legal Entity Address: 257 West Genesee Street City: Latham City: Buffalo State: NY State: NY Zip: Zip: Last Updated: 9/3/2008 Legal Entity Name: HEALTHNOW NEW YORK, INC. Contract Number: H2648 Organization Marketing Name: Traditional Blue Medicare PFFS Parent Organization: HealthNow New York Inc. Organization Type: PFFS Division Mgr, Commercial Gov't Programs Plan Type: PFFS Name: Linda Warren Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: 30 Century Hill Drive Legal Entity Address: 257 West Genesee Street City: Latham City: Buffalo State: NY State: NY Zip: Zip: Last Updated: 2/28/2007 Legal Entity Name: HEALTHPARTNERS INSURANCE COMPANY Contract Number: H9931 Organization Marketing Name: HealthPartners Liberty Medicare Parent Organization: HealthPartners, Inc. Organization Type: PFFS Plan Type: PFFS Name: Provider Services Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 98 [email protected] Address: rd Avenue South Legal Entity Address: rd Ave. S PO Box 1309 City: Minneapolis City: Bloomington State: MN State: MN Zip: Zip: Last Updated: 4/24/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 82 of 190
83 Legal Entity Name: HEALTHPARTNERS, INC. Contract Number: H2422 Organization Marketing Name: HealthPartners Classic MN Senior Health Options Parent Organization: HealthPartners, Inc. Name: Provider Services Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 2,698 Address: rd Avenue South Legal Entity Address: TH AVENUE SOUTH PO Box 1309 City: Minneapolis City: BLOOMINGTON State: MN State: MN Zip: Zip: Last Updated: 4/25/2008 Legal Entity Name: HEALTHPARTNERS, INC. Contract Number: H9005 Organization Marketing Name: HealthPartners Classic Plan Parent Organization: HealthPartners, Inc. Name: Provider Services Contract Effective Date: 5/1/1984 Phone: CMS Region Responsible: Chicago Enrollment: Address: rd Avenue South Legal Entity Address: rd AVENUE SOUTH PO Box 1309 PO BOX 1309 City: Minneapolis City: Minneapolis State: MN State: MN Zip: Zip: Last Updated: 8/11/2008 Legal Entity Name: HEALTHPLUS OF MICHIGAN Contract Number: H2354 Organization Marketing Name: HealthPlus of Michigan Parent Organization: HealthPlus of Michigan Director of Medicare Services Name: Jacob Collins Contract Effective Date: 4/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: 11,099 Address: 2050 S. Linden Road Legal Entity Address: 2050 S. Linden Road P.O. Box 1700 P.O. BOX 1700 City: Flint City: FLINT State: MI State: MI Zip: Zip: Last Updated: 3/17/2009 Legal Entity Name: HEALTHPLUS PHSP, INC. Contract Number: H6264 Organization Marketing Name: Health Plus Elite Parent Organization: Lutheran Medical Center VP, Network Management Name: Cleo Dixon Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: New York Enrollment: Address: 335 Adams Street Legal Entity Address: 335 Adams Street, 26 Floor 26th Floor City: Brooklyn City: Brooklyn State: NY State: NY Zip: Zip: Last Updated: 3/4/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 83 of 190
84 Legal Entity Name: HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. Contract Number: H7787 Organization Marketing Name: HealthSpring Medicare Advantage Parent Organization: HealthSpring, Inc. Vice President of Customer Service Name: Wendy Wetzel Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: 1,553 Address: 2900 North Loop West Suite 1300 Legal Entity Address: 2900 North Loop West Suite 300 City: Houston City: Houston State: TX State: TX Zip: Zip: Last Updated: 2/5/2009 Legal Entity Name: HEALTHSPRING OF ALABAMA, INC. Contract Number: H0150 Organization Marketing Name: Healthspring of Alabama, Inc. Parent Organization: HealthSpring, Inc. Vice President of Customer Service Name: Wendy Wetzel Contract Effective Date: 3/1/1994 Phone: CMS Region Responsible: Denver Enrollment: 30,013 Address: 2900 North Loop West Legal Entity Address: Two Chase Corporate Drive Suite 1300 Ste 300 City: Houston City: BIRMINGHAM State: TX State: AL Zip: Zip: Last Updated: 12/18/2008 Legal Entity Name: HEALTHSPRING OF FLORIDA, INC. Contract Number: H5410 Organization Marketing Name: HealthSpring of Florida, Inc. Parent Organization: HealthSpring, Inc. Vice President of Customer Service Name: Wendy Wetzel Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 30,740 Address: 2900 North Loop West Legal Entity Address: SW 40 Street, Suite 400 Suite 1300 City: Houston City: MIAMI State: TX State: FL Zip: Zip: Last Updated: 2/10/2009 Legal Entity Name: HEALTHSPRING OF TENNESSEE, INC. Contract Number: H1415 Organization Marketing Name: HealthSpring, Inc. Parent Organization: HealthSpring, Inc. Vice President, Customer Service Name: Wendy Wetzel Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 10,683 Address: 2900 North Loop West Legal Entity Address: 9701 W Higgins Road Suite1300 SUITE 360 City: Houston City: Rosemont State: TX State: IL Zip: Zip: Last Updated: 12/3/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 84 of 190
85 Legal Entity Name: HEALTHSPRING OF TENNESSEE, INC. Contract Number: H4407 Organization Marketing Name: Healthspring, Inc. Parent Organization: HealthSpring, Inc. Vice President of Customer Service Name: Wendy Wetzel Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 4,035 Address: 2900 North Loop West Legal Entity Address: 44 VANTAGE WAY Suite 1300 SUITE 300 City: Houston City: NASHVILLE State: TX State: TN Zip: Zip: Last Updated: 12/18/2008 Legal Entity Name: HEALTHSPRING OF TENNESSEE, INC. Contract Number: H4454 Organization Marketing Name: Healthspring Parent Organization: HealthSpring, Inc. 10/1/1996 For Profit CMS Region Responsible: Denver Enrollment: 55,628 Vice President of Customer Service Name: Wendy Wetzel Phone: Address: 2900 North Loop West Contract Effective Date: Tax Status: 3379 Legal Entity Address: 44 VANTAGE WAY, SUITE 300 Suite 1300 City: Houston City: NASHVILLE State: TX State: TN Zip: Zip: Last Updated: 2/5/2009 Legal Entity Name: HEALTHSUN HEALTH PLANS, INC. Contract Number: H5431 Organization Marketing Name: HealthSun Health Plans, Inc. Parent Organization: HealthSun Health Plans, Inc Vice President Name: Jonathan Klein Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 2,994 Address: 1205 SW 37th Avenue Legal Entity Address: 1205 SOUTHWEST 37TH AVENUE, 2ND FLOOR City: Miami City: MIAMI State: FL State: FL Zip: Zip: Last Updated: 4/17/2007 Legal Entity Name: HEALTHY ALLIANCE LIFE INSURANCE COMPANY Contract Number: H2613 Organization Marketing Name: Blue Cross Blue Shield of Missouri Parent Organization: Wellpoint, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 4,959 Address: 1831 Chestnut Street Legal Entity Address: 1 WellPoint Way M CAT201-C004 City: St. Louis City: Thousand Oaks State: MO Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 85 of 190
86 Legal Entity Name: HEART OF AMERICA HMO Contract Number: H3503 Organization Marketing Name: Heart of America Health Plan Parent Organization: Heart of America HMO Organization Type: 1876 Cost Plan Type: 1876 Cost Marketing Representative Name: Scott Todahl Contract Effective Date: 1/1/1984 Phone: CMS Region Responsible: Denver Enrollment: Address: 810 So. Main Avenue Legal Entity Address: 810 SOUTH MAIN STREET City: Rugby City: RUGBY State: ND State: ND Zip: Zip: Last Updated: 7/18/2008 Legal Entity Name: HENRY FORD HEALTH SYSTEM Contract Number: H2318 Organization Marketing Name: Henry Ford Health System Parent Organization: Henry Ford Health System Organization Type: National PACE Plan Type: National PACE 11/1/2003 Director Name: Linda McCarver Phone: Contract Effective Date: CMS Region Responsible: Chicago Enrollment: Address: 7800 W Outer Drive Legal Entity Address: 7800 W. OUTER DRIVE, SUITE 240 Suite 240 City: Detroit City: DETROIT State: MI State: MI Zip: Zip: Last Updated: 5/19/2008 Legal Entity Name: HIGHMARK HEALTH INSURANCE COMPANY Contract Number: H5106 Organization Marketing Name: Highmark Health Insurance Company Parent Organization: Highmark Inc. VP, Sr. Products Operations Name: Sally Rich Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: 8,578 [email protected] Address: 120 Fifth Avenue Legal Entity Address: 120 Fifth Avenue City: Pittsburgh P5501 City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 2/28/2007 Legal Entity Name: HIGHMARK, INC. Contract Number: H3916 Organization Marketing Name: Highmark Inc. Parent Organization: Highmark Inc. VP, Sr. Products Operations Name: Sally Rich Contract Effective Date: 5/1/2003 Phone: CMS Region Responsible: Philadelphia Enrollment: 83,079 [email protected] Address: 120 Fifth Avenue Legal Entity Address: FIFTH AVENUE PLACE - SUITE P5501 Suite P FIFTH AVENUE City: Pittsburgh City: PITTSBURGH State: PA State: PA Zip: Zip: Last Updated: 8/21/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 86 of 190
87 Legal Entity Name: HIGHMARK, INC. Contract Number: H9793 Organization Marketing Name: Highmark Inc. Parent Organization: Highmark Inc. Organization Type: PFFS Plan Type: PFFS Vice President, Operations Name: Sally Rich Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: 20,574 Address: 120 Fifth Avenue Legal Entity Address: 120 Fifth Avenue Suite P5501 Suite P5501 City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 5/18/2007 Legal Entity Name: HIP OF GREATER NEW YORK Contract Number: H3314 Organization Marketing Name: HIP Health Plan of Greater New York Parent Organization: EmblemHealth Inc. Organization Type: 1876 Cost Manager, Outbound Customer Service Plan Type: 1876 Cost Name: Willie Horne Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: New York Enrollment: 1,419 Address: 55 Water Street Legal Entity Address: 7 WEST 34TH STREET City: New York City: NEW YORK State: NY State: NY Zip: Zip: Last Updated: 11/21/2008 Legal Entity Name: HIP OF GREATER NEW YORK Contract Number: H3330 Organization Marketing Name: HIP Medicare HMO Parent Organization: EmblemHealth Inc. Manager, Outbound Customer Service Name: Willie Horne Contract Effective Date: 7/1/1987 Phone: CMS Region Responsible: New York Enrollment: 130,439 [email protected] Address: 55 Water Street Legal Entity Address: 55 Water Street City: New York City: NEW YORK State: NY State: NY Zip: Zip: Last Updated: 11/18/2008 Legal Entity Name: HM HEALTH INSURANCE COMPANY Contract Number: H1643 Organization Marketing Name: Highmark Health Insurance Company Parent Organization: Highmark Inc. Organization Type: PFFS Plan Type: PFFS VP, Sr. Products Operations Name: Sally Rich Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: 120 Fifth Avenue Legal Entity Address: 120 Fifth Avenue Suite P5501 Suite P5501 City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 8/22/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 87 of 190
88 Legal Entity Name: HMO CALIFORNIA Contract Number: H0838 Organization Marketing Name: Brand New Day Parent Organization: Universal Care, Inc VP Operations and Compliance Name: Connie Snyder Contract Effective Date: 4/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 1,360 Address: 1600 E Hill Street Legal Entity Address: 1680 EAST HILL STREET Building 3 City: Signal Hill City: SIGNAL HILL State: AL Zip: Zip: Last Updated: 5/11/2009 Legal Entity Name: HMO COLORADO, INC. Contract Number: H5679 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: HMO MINNESOTA D/B/A BLUE PLUS Contract Number: H0974 Organization Marketing Name: Blue Plus Parent Organization: Blue Cross and Blue Shield of Minnesota Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 3400 Yankee Drive Legal Entity Address: 3400 Yankee Drive City: Eagan City: Eagan State: MN State: MN Zip: Zip: Last Updated: 10/4/2006 Legal Entity Name: HMO MISSOURI, INC. Contract Number: H9466 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 39 [email protected] Address: 4241 Irwin Simpson Road Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Mason City: Thousand Oaks State: OH Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 88 of 190
89 Legal Entity Name: HOMETOWN HEALTH PLAN Contract Number: H2906 Organization Marketing Name: Senior Care Plus Parent Organization: Renown Health Customer Services Manager Name: John Osmond Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 830 Harvard Way Legal Entity Address: 830 HARVARD WAY City: Reno City: RENO State: NV State: NV Zip: Zip: Last Updated: 9/20/2007 Legal Entity Name: HOMETOWN HEALTH PLAN Contract Number: H2960 Organization Marketing Name: Senior Care Plus Parent Organization: Renown Health Customer Services Manager Name: John Osmond Contract Effective Date: 10/1/1995 Phone: CMS Region Responsible: San Francisco Enrollment: 5,252 Address: 830 Harvard Way Legal Entity Address: 830 Harvard Way City: Reno City: RENO State: NV State: NV Zip: Zip: Last Updated: 9/20/2007 Legal Entity Name: HOMETOWN HEALTH PLAN Contract Number: H3672 Organization Marketing Name: The Health Plan Parent Organization: Health Plan of the Upper Ohio Valley Director Member Services Name: Sherry Stanley Contract Effective Date: 3/1/1997 Phone: CMS Region Responsible: Philadelphia Enrollment: 8,411 Address: The Health Plan Legal Entity Address: National Road East City: St. Clairsville National Road East City: St. Clairsville State: OH State: OH Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: HOPE HOSPICE AND COMMUNITY SERVICES, INC. Contract Number: H5934 Organization Marketing Name: Hope Select Care Parent Organization: HOPE OF SOUTHWEST FLORIDA, INC. Organization Type: National PACE Plan Type: National PACE Business Analyst Name: Ron Burris Contract Effective Date: 3/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 65 Address: 2668 Winkler Ave. Legal Entity Address: 9470 HealthPark Circle City: Ft. Myers City: Fort Myers State: FL State: FL Zip: Zip: Last Updated: 2/1/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 89 of 190
90 Legal Entity Name: HORIZON BLUE CROSS BLUE SHIELD OF NJ Contract Number: H1991 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 Director, Consumer & Senior Markets Plan Type: PFFS Name: John Selby Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: Three Penn Plaza East, PP-09F Legal Entity Address: 3 Penn Plaza East City: Newark City: Newark State: NJ State: NJ Zip: Zip: Last Updated: 9/29/2008 Legal Entity Name: HORIZON HEALTHCARE OF NEW JERSEY, INC. Contract Number: H3154 Organization Marketing Name: Horizon Blue Cross Blue Shield of New Jersey, Inc. Parent Organization: Horizon Blue Cross Blue Shield of New Jersey, Inc. Director, Consumer & Senior Markets Name: John Selby Contract Effective Date: 1/1/1996 Phone: CMS Region Responsible: New York Enrollment: 54,763 [email protected] Address: Three Penn Plaza East, PP-09F Legal Entity Address: 3 PENN PLAZA EAST City: Newark City: NEWARK State: NJ State: NJ Zip: Zip: Last Updated: 9/29/2008 Legal Entity Name: HUMANA ADVANTAGECARE PLAN, INC. Contract Number: H5426 Organization Marketing Name: Humana AdvantageCare Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 8,500 [email protected] Address: 101 East Main Street Legal Entity Address: 3501 SW 160th Avenue City: Louisville City: Miramar State: KY State: FL Zip: Zip: Last Updated: 9/11/2008 Legal Entity Name: HUMANA HEALTH BENEFIT PLAN OF LA, INC. Contract Number: H1906 Organization Marketing Name: Humana Health Benefit Plan of LA, Inc. Parent Organization: Humana Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 5,952 [email protected] Address: 101 East Main Street Legal Entity Address: 1 Galleria Boulevard., Suite 850 City: Louisville City: Metairie State: KY State: LA Zip: Zip: Last Updated: 2/11/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 90 of 190
91 Legal Entity Name: HUMANA HEALTH BENEFIT PLAN OF LOUISIANA INC Contract Number: H1951 Organization Marketing Name: Humana Health Benefit Plan of Louisiana Inc Parent Organization: Humana Inc. Contract Effective Date: 6/1/1994 Phone: CMS Region Responsible: Kansas City Enrollment: 67,009 Address: 101 East Main Street Legal Entity Address: 1 Galleria Boulevard., Suite 850 City: Louisville City: Metairie State: KY State: LA Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA HEALTH INSURANCE COMPANY OF FL, INC. Contract Number: H5415 Organization Marketing Name: Humana Health Insurance Company of FL, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: [email protected] Address: 101 East Main Street Legal Entity Address: 3501 SW 160th Avenue City: Louisville City: Miramar State: KY State: FL Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA HEALTH PLAN OF TEXAS,INC. Contract Number: H4510 Organization Marketing Name: Humana Health Plan of Texas, Inc. Parent Organization: Humana Inc. Contract Effective Date: 3/1/1988 Phone: CMS Region Responsible: Kansas City Enrollment: 32,589 [email protected] Address: 101 East Main Street Legal Entity Address: 1221 South Mopac, Suite 200 City: Louisville City: Austin State: KY State: TX Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA HEALTH PLAN, INC. Contract Number: H0307 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 4/1/1988 Phone: CMS Region Responsible: Kansas City Enrollment: 11,268 [email protected] Address: 101 East Main Street Legal Entity Address: 201 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 91 of 190
92 Legal Entity Name: HUMANA HEALTH PLAN, INC. Contract Number: H1406 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 7/1/1985 Phone: CMS Region Responsible: Kansas City Enrollment: 27,518 Address: 101 East Main Street Legal Entity Address: 201 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA HEALTH PLAN, INC. Contract Number: H2649 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/1990 Phone: CMS Region Responsible: Kansas City Enrollment: 21,595 Address: 101 East Main Street Legal Entity Address: 201 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA HEALTH PLAN, INC. Contract Number: H2949 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 10/1/1992 Phone: CMS Region Responsible: Kansas City Enrollment: 26,132 Address: 101 East Main Street Legal Entity Address: 201 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 4/16/2008 Legal Entity Name: HUMANA HEALTH PLAN, INC. Contract Number: H3028 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: Address: 101 East Main Street Legal Entity Address: 321 West Main Street, 12th Floor City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 2/8/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 92 of 190
93 Legal Entity Name: HUMANA HEALTH PLAN, INC. Contract Number: H5291 Organization Marketing Name: Humana Health Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 1,338 Address: 101 East Main Street Legal Entity Address: 201 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 3/6/2007 Legal Entity Name: HUMANA HEALTH PLANS OF PUERTO RICO INC Contract Number: H4007 Organization Marketing Name: Humana Health Plans Of Puerto Rico Inc Parent Organization: Humana Inc. Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 10,984 Address: 101 East Main Street Legal Entity Address: 383 F.D. Roosevelt Avenue, 3rd Floor City: Louisville City: San Juan State: KY State: PR Zip: Zip: Last Updated: 2/11/2009 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H0248 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: 1,848 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 1/31/2008 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H0317 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 8,498 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 93 of 190
94 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H0623 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 2,950 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H1418 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 5,977 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H1510 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 8,091 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H1681 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: 1,362 Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd. City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 94 of 190
95 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H1716 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 11,447 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H1804 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2003 Phone: CMS Region Responsible: Kansas City Enrollment: 564,205 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/11/2009 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H1806 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 12,406 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H2542 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: 5,985 Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd. City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 95 of 190
96 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H3405 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 1,488 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H3619 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 13,436 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H4408 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 3,595 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H4520 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 10,904 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 96 of 190
97 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H4606 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 14,486 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H4956 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: 2,094 Address: 101 East Main Street Legal Entity Address: 110 Employers Blvd. City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H5041 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd. City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H5214 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 8,656 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 97 of 190
98 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H5216 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 2,816 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H5470 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: * [email protected] Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 3/6/2007 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H5868 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 2,281 [email protected] Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 3/7/2007 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H6411 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 1,787 [email protected] Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 3/7/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 98 of 190
99 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H6900 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd. City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H7002 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: 21 Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd. City: Louisville City: Depere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H7188 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 5,706 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 3/7/2007 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H8644 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 6,116 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 3/7/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 99 of 190
100 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H8707 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 3,439 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 3/7/2007 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: H9503 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Kansas City Enrollment: 1,128 Address: 101 East Main Street Legal Entity Address: 1100 Employers Blvd. City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 2/8/2008 Legal Entity Name: HUMANA INSURANCE COMPANY Contract Number: R5826 Organization Marketing Name: Humana Insurance Company Parent Organization: Humana Inc. Organization Type: Regional CCP Plan Type: Regional PPO Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Kansas City Enrollment: 181,684 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: HUMANA INSURANCE COMPANY OF NEW YORK Contract Number: H5657 Organization Marketing Name: Humana Insurance Company of New York Parent Organization: Humana Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Kansas City Enrollment: 5,090 Address: 101 East Main Street Legal Entity Address: 500 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 2/11/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 100 of 190
101 Legal Entity Name: HUMANA INSURANCE OF PUERTO RICO, INC Contract Number: H4008 Organization Marketing Name: Humana Insurance Of Puerto Rico, Inc Parent Organization: Humana Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: Address: 101 East Main Street Legal Entity Address: 383 F.D. Roosevelt Avenue, 3rd Floor City: Louisville City: San Juan State: KY State: PR Zip: Zip: Last Updated: 2/11/2009 Legal Entity Name: HUMANA INSURANCE OF PUERTO RICO, INC. Contract Number: H2029 Organization Marketing Name: Humana Insurance of Puerto Rico, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 1,792 Address: 101 East Main Street Legal Entity Address: 383 F.D. Roosevelt Avenue 3rd Floor City: San Juan PR City: Louisville State: KY Zip: Last Updated: State: Zip: 2/11/2009 Legal Entity Name: HUMANA MEDICAL PLAN OF UTAH Contract Number: H2486 Organization Marketing Name: Humana Medical Plan of Utah Parent Organization: Humana Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: Address: 101 East Main Street Legal Entity Address: 500 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 3/6/2007 Legal Entity Name: HUMANA MEDICAL PLAN, INC Contract Number: H1036 Organization Marketing Name: Humana Medical Plan, Inc. Parent Organization: Humana Inc. Contract Effective Date: 2/1/1986 Phone: CMS Region Responsible: Kansas City Enrollment: 264,278 Address: 101 East Main Street Legal Entity Address: 3501 SW 160th Avenue City: Louisville City: Miramar State: KY State: FL Zip: Zip: Last Updated: 8/22/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 101 of 190
102 Legal Entity Name: IEHP HEALTH ACCESS Contract Number: H5640 Organization Marketing Name: IEHP Medicare DualChoice Parent Organization: INLAND EMPIRE HEALTH PLAN Member Services Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 2,635 Address: 303 E. Vanderbilt Way, Suite 100 Legal Entity Address: 303 E. Vanderbilt Way Suite 100 City: San Bernardino City: San Bernardino Zip: Zip: Last Updated: 2/5/2009 Legal Entity Name: INDEPENDENT CARE HEALTH PLAN, INC. Contract Number: H2237 Organization Marketing Name: icare Parent Organization: Independent Care Health Plan Inc. Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: 3,017 Address: 1555 N Rivercenter Drive Legal Entity Address: 1555 North River Center Drive Suite 202A Suite 206 City: Milwaukee City: Milwaukee State: WI State: WI Zip: Zip: Last Updated: 3/18/2008 Legal Entity Name: INDEPENDENT HEALTH ASSOCIATION, INC. Contract Number: H3362 Organization Marketing Name: Independent Health Parent Organization: Independent Health Association, Inc. Name: Member Services Contract Effective Date: 1/1/1996 Phone: CMS Region Responsible: New York Enrollment: 50,818 [email protected] Address: 511 Farber Lakes Drive Legal Entity Address: 511 FARBER LAKES DRIVE City: Buffalo City: BUFFALO State: NY State: NY Zip: Zip: Last Updated: 1/8/2008 Legal Entity Name: INDEPENDENT HEALTH BENEFITS CORPORATION Contract Number: H3344 Organization Marketing Name: Independent Health Parent Organization: Independent Health Association, Inc. Name: Member Services Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: New York Enrollment: 3,245 [email protected] Address: 511 Farber Lakes Drive Legal Entity Address: 511 FARBER LAKES DRIVE City: Buffalo City: BUFFALO State: NY State: NY Zip: Zip: Last Updated: 1/8/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 102 of 190
103 Legal Entity Name: INDEPENDENT HEALTH BENEFITS CORPORATION Contract Number: H9519 Organization Marketing Name: Independent Health Parent Organization: Independent Health Association, Inc. Organization Type: PFFS Plan Type: PFFS Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: Address: 511 Farber Lakes Drive Legal Entity Address: 511 Farber Lakes Drive City: Buffalo City: Buffalo State: NY State: NY Zip: Zip: Last Updated: 1/8/2008 Legal Entity Name: INDEPENDENT LIVING FOR SENIORS, INC. Contract Number: H3331 Organization Marketing Name: Independent Living For Seniors, Inc. Parent Organization: Rochester General Hospital Organization Type: National PACE Plan Type: National PACE Name: Tina Farrell-Huber Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: New York Enrollment: Address: 2066 Hudson Avenue Legal Entity Address: 2066 HUDSON AVENUE City: Rochester City: ROCHESTER State: NY State: NY Zip: Zip: Last Updated: 10/16/2008 Legal Entity Name: INDEPENDENT LIVING SRVCS OF CENTRAL NY Contract Number: H3321 Organization Marketing Name: Independent Living Srvcs Of Central Ny Parent Organization: Loretto Rest Realty Corporation Organization Type: National PACE Plan Type: National PACE Name: Ginny Turley Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: New York Enrollment: Address: 100 Malta Lane Legal Entity Address: 100 MALTA LANE City: North Syracuse City: NORTH SYRACUSE State: NY State: NY Zip: Zip: Last Updated: 12/19/2007 Legal Entity Name: INSTIL HEALTH INSURANCE COMPANY Contract Number: H4204 Organization Marketing Name: InStil Health Insurance Company Parent Organization: BlueCross BlueShield of South Carolina (BCBSSC) Organization Type: PFFS Plan Type: PFFS 4/1/2005 Manager, Contracts & Administration Name: Dee A Yurko Phone: Contract Effective Date: CMS Region Responsible: Atlanta Enrollment: 10,464 [email protected] Address: P. O. Box Legal Entity Address: P.O. BOX Mail Code AG-790 AG-790 City: Columbia City: COLUMBIA State: SC State: SC Zip: Zip: Last Updated: 4/28/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 103 of 190
104 Legal Entity Name: INTER VALLEY HEALTH PLAN, INC. Contract Number: H0545 Organization Marketing Name: Inter Valley Health Plan Parent Organization: InterValley Health Plan Manager, Enrollment & Reimbursement Name: Kim Porter Contract Effective Date: 6/1/1986 Phone: CMS Region Responsible: San Francisco Enrollment: 12,264 Address: 300 S. Park Ave. Legal Entity Address: 300 SOUTH PARK PO BOX 6002 City: Pomona City: POMONA Zip: Zip: Last Updated: 9/19/2006 Legal Entity Name: ITASCA MEDICAL CARE Contract Number: H2417 Organization Marketing Name: Itasca Medical Care Parent Organization: Itasca County Health & Human Services 6/1/2005 Program Director Name: Brett Skyles Phone: Contract Effective Date: CMS Region Responsible: Chicago Enrollment: Address: 1219 SE 2nd Ave. Legal Entity Address: 1219 SE 2ND AVENUE City: Grand Rapids City: GRAND RAPIDS State: MN State: MN Zip: Zip: Last Updated: 5/15/2007 Legal Entity Name: JOHNS HOPKINS HEALTH SYSTEM, INC. Contract Number: H2109 Organization Marketing Name: Hopkins ElderPlus Parent Organization: Johns Hopkins Health System Corporation Organization Type: National PACE Director Plan Type: National PACE Name: Karen Armacost Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: Philadelphia Enrollment: 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 State: MD Zip: Zip: Last Updated: 8/19/2008 Legal Entity Name: KAISER FNDN HP OF THE MID-ATLANTIC STS Contract Number: H2150 Organization Marketing Name: Kaiser Permanente Medicare Plus Parent Organization: Kaiser Foundation Health Plan, Inc. Organization Type: 1876 Cost Member Services Plan Type: 1876 Cost Name: Daisy Strickland Contract Effective Date: 1/1/1991 Phone: CMS Region Responsible: San Francisco Enrollment: 37,025 Address: 2101 East Jefferson St, 2nd floor West Legal Entity Address: 2101 EAST JEFFERSON STREET ATTN: Medicare Unit City: Rockville City: ROCKVILLE State: MD State: MD Zip: Zip: Last Updated: 11/20/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 104 of 190
105 Legal Entity Name: KAISER FOUNDATION HP OF CO Contract Number: H0630 Organization Marketing Name: Kaiser Permanente Senior Advantage Parent Organization: Kaiser Foundation Health Plan, Inc. Name: Member Services Contract Effective Date: 1/1/1986 Phone: CMS Region Responsible: San Francisco Enrollment: 63,788 Address: 2500 S. Havana St. Legal Entity Address: E Dakota Avenue PO Box City: Aurora City: Denver State: CO State: CO Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: KAISER FOUNDATION HP OF GA, INC. Contract Number: H1170 Organization Marketing Name: Kaiser Permanente Senior Advantage Parent Organization: Kaiser Foundation Health Plan, Inc. Name: Member Services Contract Effective Date: 1/1/1997 Phone: CMS Region Responsible: San Francisco Enrollment: 14,868 [email protected] Address: 3495 Piedmont Road NE Legal Entity Address: 3495 PIEDMONT ROAD BUILDING 9 City: ATLANTA GA City: Atlanta State: GA Zip: Last Updated: State: Zip: 11/21/2008 Legal Entity Name: KAISER FOUNDATION HP OF OHIO Contract Number: H6360 Organization Marketing Name: Kaiser Permanente Medicare Plus Parent Organization: Kaiser Foundation Health Plan, Inc. Organization Type: 1876 Cost Department Plan Type: 1876 Cost Name: Customer Relations Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 19,901 [email protected] Address: 5500 Lancaster Drive Legal Entity Address: North Point Tower, Suite Lakeside Avenue City: Brooklyn Heights City: CLEVELAND State: OH State: OH Zip: Zip: Last Updated: 10/2/2008 Legal Entity Name: KAISER FOUNDATION HP OF THE N W Contract Number: H9003 Organization Marketing Name: Kaiser Permanente Parent Organization: Kaiser Foundation Health Plan, Inc. Name: Member Services Contract Effective Date: 4/1/1980 Phone: CMS Region Responsible: San Francisco Enrollment: 51,145 [email protected] Address: 500 NE Multnomah St.,Suite 100 Legal Entity Address: 500 NE Multnomah St SUITE 100 City: Portland City: PORTLAND State: OR State: OR Zip: Zip: Last Updated: 4/5/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 105 of 190
106 Legal Entity Name: KAISER FOUNDATION HP OF THE N W Contract Number: H9103 Organization Marketing Name: Kaiser Permanente Parent Organization: Kaiser Foundation Health Plan, Inc. Name: Member Services Contract Effective Date: 3/1/1985 Phone: CMS Region Responsible: San Francisco Enrollment: 2,487 [email protected] Address: 500 NE Multnomah St.,Suite 100 Legal Entity Address: 500 NE Multnomah St SUITE 500 City: Portland City: PORTLAND State: OR State: OR Zip: Zip: Last Updated: 4/5/2007 Legal Entity Name: KAISER FOUNDATION HP, INC. Contract Number: H0524 Organization Marketing Name: Kaiser Permanente Senior Advantage Parent Organization: Kaiser Foundation Health Plan, Inc. Name: Member Services Contract Effective Date: 8/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 706,912 [email protected] Address: 393 E Walnut St Fl 7 Legal Entity Address: P.O. BOX City: Pasadena City: OAKLAND Zip: Zip: Last Updated: 4/17/2009 Legal Entity Name: KAISER FOUNDATION HP, INC. Contract Number: H1200 Organization Marketing Name: Kaiser Permanente Medicare Cost Parent Organization: Kaiser Foundation Health Plan, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 711 Kapiolani Blvd Legal Entity Address: 711 KAPIOLANI BLVD City: Honolulu City: HONOLULU State: HI State: HI Zip: Zip: Last Updated: 8/14/2008 Legal Entity Name: KAISER FOUNDATION HP, INC. Contract Number: H1230 Organization Marketing Name: Kaiser Permanente Senior Advantage Parent Organization: Kaiser Foundation Health Plan, Inc. Contract Effective Date: 5/1/1986 Phone: CMS Region Responsible: San Francisco Enrollment: 23,121 [email protected] Address: 711 Kapiolani Blvd Legal Entity Address: 711 KAPIOLANI BLVD City: Honolulu City: HONOLULU State: HI State: HI Zip: Zip: Last Updated: 8/14/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 106 of 190
107 Legal Entity Name: KAISER FOUNDATION HP, INC. Contract Number: H6050 Organization Marketing Name: Kaiser Permanente Medicare Cost Parent Organization: Kaiser Foundation Health Plan, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Name: Member Services Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 1,193 Address: 393 E Walnut St Fl 7 Legal Entity Address: P.O.BOX City: Pasadena City: OAKLAND Zip: Zip: Last Updated: 4/17/2009 Legal Entity Name: KAISER FOUNDATION HP, INC. Contract Number: H6052 Organization Marketing Name: Kaiser Permanente Medicare Cost Parent Organization: Kaiser Foundation Health Plan, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Name: Member Services Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 4,140 [email protected] Address: 393 E Walnut St Fl 7 Legal Entity Address: ONE KAISER PLAZA City: Pasadena City: OAKLAND Zip: Zip: Last Updated: 4/17/2009 Legal Entity Name: KEYSTONE HEALTH PLAN CENTRAL,INC. Contract Number: H3962 Organization Marketing Name: Keystone Health Plan Central, Inc. Parent Organization: Capital BlueCross Customer Service Manager Name: Jayne Dailey Contract Effective Date: 5/1/1996 Phone: CMS Region Responsible: Philadelphia Enrollment: 17,788 [email protected] Address: 2500 Elmerton Avenue Legal Entity Address: P.O. Box City: Harrisburg City: HARRISBURG State: PA State: PA Zip: Zip: Last Updated: 7/6/2007 Legal Entity Name: KEYSTONE HEALTH PLAN EAST, INC. Contract Number: H3952 Organization Marketing Name: Keystone 65 Parent Organization: Independence Blue Cross Name: Plan Inquiries Contract Effective Date: 1/1/1993 Phone: CMS Region Responsible: Philadelphia Enrollment: 122,974 [email protected] Address: 1901 Market Street Legal Entity Address: 1901 MARKET STREET 45TH FLOOR City: Phila City: PHILADELPHIA State: PA State: PA Zip: Zip: Last Updated: 9/6/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 107 of 190
108 Legal Entity Name: KEYSTONE HEALTH PLAN WEST, INC. Contract Number: H3957 Organization Marketing Name: Keystone Health Plan West, Inc. Parent Organization: Highmark Inc. VP, Sr. Products Operations Name: Sally Rich Contract Effective Date: 3/1/1995 Phone: CMS Region Responsible: Philadelphia Enrollment: 170,095 Address: 120 Fifth Avenue Legal Entity Address: 120 5TH AVENUE Suite P5501 SUITE 3152 City: Pittsburgh City: PITTSBURGH State: PA State: PA Zip: Zip: Last Updated: 8/31/2006 Legal Entity Name: KS PLAN ADMINISTRATORS, LLC Contract Number: H0332 Organization Marketing Name: KelseyCare Advantage Parent Organization: KS Plan Administrators, LLC Name: Member Services Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 9,740 Address: 8900 Lakes at 610 Dr. Suite 1100 Legal Entity Address: 2727 West Holcombe 4th Floor, Admin City: Houston TX City: Houston State: TX Zip: Last Updated: State: Zip: 1/14/2008 Legal Entity Name: L. A. CARE HEALTH PLAN Contract Number: H2643 Organization Marketing Name: L.A. Care Health Plan Parent Organization: L.A. Care Health Plan Director Medicare and Product Operations Name: Scott A Crawford Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 555 West 5th Street Legal Entity Address: 555 West 5th Street 29th Floor 29th Floor City: Los Angeles City: Los Angeles Zip: Zip: Last Updated: 2/20/2007 Legal Entity Name: LIBERTY HEALTH ADVANTAGE, INC. Contract Number: H3337 Organization Marketing Name: Liberty Health Advantage Parent Organization: Liberty Health Advantage, Inc. Name: Tobias Germoso Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: New York Enrollment: 2,676 [email protected] Address: One Huntington Quadrangle Legal Entity Address: 1 Huntington Quadrangle, Suite 3N01 Suite 3N01 City: Melville City: Melville State: NY State: NY Zip: Zip: Last Updated: 3/19/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 108 of 190
109 Legal Entity Name: LIFE AT HOME, LLC Contract Number: H2699 Organization Marketing Name: Life at Home, LLC Parent Organization: LIFE AT HOME, LLC Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 7/1/2007 CMS Region Responsible: Philadelphia Enrollment: 54 Legal Entity Address: 101 E State St. City: Kennett Square State: PA Zip: Legal Entity Name: LIFE LUTHERAN Contract Number: H2537 Organization Marketing Name: LIFE Lutheran Services, Inc. Parent Organization: Lutheran Social Services of South Central PA Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 9/1/2008 CMS Region Responsible: Philadelphia Enrollment: * Legal Entity Address: 840 Fifth Avenue City: Chambersburg State: PA Zip: Legal Entity Name: LIFE ST. FRANCIS Contract Number: H1234 Organization Marketing Name: LIFE St. Francis Parent Organization: Life St. Francis Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 4/1/2009 CMS Region Responsible: New York Enrollment: * Legal Entity Address: 1435 Liberty St. City: Hamilton State: NJ Zip: Legal Entity Name: LIFECIRCLES Contract Number: H2936 Organization Marketing Name: LIFECIRCLES Parent Organization: LifeCircles Organization Type: National PACE Plan Type: National PACE Contract Effective Date: 2/1/2009 CMS Region Responsible: Chicago Enrollment: 11 Legal Entity Address: 560 Seminole Road City: Muskegon State: MI Zip: Finance Director Name: Karen M Wells Phone: [email protected] Address: 101 East State Street City: Kennett Square State: PA Zip: Last Updated: 5/1/2008 Executive Director Name: Mary Fredette Phone: [email protected] Address: 840 Fifth Avenue City: Chambersburg State: PA Zip: Last Updated: 10/15/2008 Name: Jill Ann Viggiano Phone: [email protected] Address: 1435 Liberty St. City: Hamilton State: NJ Zip: Last Updated: 3/18/2009 Executive Director Name: Robert H Mills Phone: [email protected] Address: 560 Seminole RD City: Muskegon State: MI Zip: Last Updated: 4/29/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 109 of 190
110 Legal Entity Name: LIVING INDEPENDENCE FOR THE ELDERLY Contract Number: H3918 Organization Marketing Name: LIFE Pittsburgh Parent Organization: Living Independence for the Elderly Organization Type: National PACE Plan Type: National PACE Director of Finance Name: Laura Schmitt Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: 875 Greentree Rd, One Parkway Center, Suite 200 Legal Entity Address: 875 Greentree Road. One Parkway Center, Suite 200 City: Pittsburgh City: PITTSBURGH State: PA State: PA Zip: Zip: Last Updated: 9/12/2006 Legal Entity Name: LOVELACE HEALTH SYSTEM, INC. Contract Number: H3251 Organization Marketing Name: Lovelace Senior Plan Parent Organization: Ardent Health Services. 11/1/1993 Compliance Coodinator Name: Karen Redman Phone: Contract Effective Date: CMS Region Responsible: Dallas Enrollment: 27,092 Address: 4101 Indian School Rd NE Legal Entity Address: ALTURA OFFICE COMPLEX 4101 INDIAN SCHOOL RD. NE City: Albuquerque City: ALBUQUERQUE State: NM State: NM Zip: Zip: Last Updated: 2/24/2009 Legal Entity Name: LOVELACE INSURANCE COMPANY Contract Number: H3207 Organization Marketing Name: Lovelace Insurance Company Parent Organization: Ardent Health Services. Medicare Compliance Officer Name: Karen L Redman Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: [email protected] Address: 4101 Indian School R. NE Legal Entity Address: 4101 INDIAN SCHOOL ROAD, N.E. City: ALBUQUERQUE Suite 110S City: Albuquerque State: NM State: NM Zip: Zip: Last Updated: 2/24/2009 Legal Entity Name: LUTHERAN SENIORLIFE LIFE-BEAVER COUNTY Contract Number: H7660 Organization Marketing Name: LIFE-Beaver County Parent Organization: Lutheran SeniorLife Organization Type: National PACE Plan Type: National PACE Director of Reimbursment Name: Katie Schick Phone: [email protected] Address: Lutheran SeniorLife 1323 Freedom Road City: Cranberry Township State: PA Zip: Contract Effective Date: 11/1/ CMS Region Responsible: Philadelphia Enrollment: 120 Legal Entity Address: 1323 Freedom Road City: Cranberry Twp. State: PA Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 110 of 190
111 Legal Entity Name: MANAGED HEALTH SERVICES, WISCONSIN Contract Number: H8189 Organization Marketing Name: Advantage by Managed Health Services Parent Organization: Centene Corporation Name: Sandi Tunis Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: * [email protected] Address: West Research Drive Legal Entity Address: West Research Drive Suite 300 Suite 300 City: Milwaukee City: Milwaukee State: WI State: WI Zip: Zip: Last Updated: 6/23/2008 Legal Entity Name: MANAGED HEALTH, INC. Contract Number: H3359 Organization Marketing Name: Healthfirst Medicare Plan Parent Organization: HealthFirst, Inc 6/1/1994 CMS Region Responsible: New York Enrollment: 82,437 Healthfirst Medicare Plan Phone: [email protected] Address: 25 Broadway, 9th Floor Contract Effective Date: Legal Entity Address: 25 BROADWAY, 9TH FLOOR City: New York City: NEW YORK State: NY State: NY Zip: Zip: Last Updated: 4/9/2008 Legal Entity Name: MAPFRE LIFE INSURANCE COMPANY Contract Number: H5821 Organization Marketing Name: MAPFRE LIFE INSURANCE COMPANY Parent Organization: MAPFRE PRAICO CORPORATION Medicare Coordinator Name: Marlene Pierce Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 9,356 [email protected] Address: PO Box Legal Entity Address: Urb. Tres Monjitas Industrial 297 Carlos Chard n Ave. City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 12/4/2007 Legal Entity Name: MARION POLK COMMUNITY HEALTH PLAN ADVANTAGE, INC. Contract Number: H5995 Organization Marketing Name: Marion Polk Community Health Plan Advantage, Inc. Parent Organization: Marion Polk Community Health Plan LLC Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Seattle Enrollment: 4,026 [email protected] Address: PO Box 5550 Legal Entity Address: 245 Commercial St. SE, Ste. 200 City: Salem City: Salem State: OR State: OR Zip: Zip: Last Updated: 2/12/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 111 of 190
112 Legal Entity Name: MARTIN'S POINT GENERATIONS, LLC Contract Number: H5591 Organization Marketing Name: Martin's Point Generations Advantage Parent Organization: Martin's Point Health Care, Inc. Name: Marketing Representative Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Boston Enrollment: 2,331 Address: P. O. Box 9746 Legal Entity Address: P.O. Box Washington Avenue 331 Veranda Street City: Portland City: Portland State: ME State: ME Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: MCKINLEY LIFE INSURANCE COMPANY Contract Number: H3620 Organization Marketing Name: PrimeTime Health Plan Parent Organization: McKinley Life Insurance Company 7/1/2005 For Profit Compliance Coordinator Name: Christine Cunningham Phone: Contract Effective Date: Tax Status: CMS Region Responsible: Chicago Enrollment: Address: 214 Dartmouth Avenue SW Legal Entity Address: 214 DARTMOUTH AVENUE S.W. City: Canton City: CANTON State: OH State: OH Zip: Zip: Last Updated: 6/22/2007 Legal Entity Name: MCKINLEY LIFE INSURANCE COMPANY Contract Number: H3664 Organization Marketing Name: PrimeTime Health Plan Parent Organization: McKinley Life Insurance Company Compliance Coordinator Name: Christine Cunningham Contract Effective Date: 1/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: 17,269 Address: 214 Dartmouth Avenue SW Legal Entity Address: 2600 SIXTH STREET SW City: Canton City: CANTON State: OH State: OH Zip: Zip: Last Updated: 6/22/2007 Legal Entity Name: MCKINLEY LIFE INSURANCE COMPANY Contract Number: H5485 Organization Marketing Name: PrimeTime Health Plan Parent Organization: McKinley Life Insurance Company Organization Type: PFFS Compliance Coordinator Plan Type: PFFS Name: Christine Cunningham Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: 1,771 Address: 214 Dartmouth Avenue SW Legal Entity Address: 2600 Sixth Street SW City: Canton City: Canton State: OH State: OH Zip: Zip: Last Updated: 6/22/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 112 of 190
113 Legal Entity Name: MCS ADVANTAGE INC. Contract Number: H4006 Organization Marketing Name: MCS Classicare Parent Organization: Medical Card System, Inc. VP A- Medicare Compliance Name: Carlos J Fournier Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: New York Enrollment: 43,007 [email protected] Address: MCS Plaza Legal Entity Address: MCS PLAZA, SUITE Ponce de Leon Avenue, Second Floor 255 PONCE DE LEON AVE. City: San Juan City: SAN JUAN State: PR State: PR Zip: Zip: Last Updated: 3/6/2009 Legal Entity Name: MCS ADVANTAGE INC. Contract Number: H5577 Organization Marketing Name: MCS Classicare Parent Organization: Medical Card System, Inc. VP A- Medicare Compliance Name: Carlos J Fournier Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 39,466 [email protected] Address: MCS Plaza Legal Entity Address: MCS Plaza, Suite Ponce de Leon Avenue, Second Floor 255 Ponce De Leon Ave. City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 3/6/2009 Legal Entity Name: MCS ADVANTAGE, INC. Contract Number: H5760 Organization Marketing Name: CosviMed Care Parent Organization: Cooperativa de Seguros de Vida de Puerto Rico VP A- Medicare Compliance Name: Carlos J Fournier Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 6,735 [email protected] Address: MCS Plaza Legal Entity Address: PO BOX Ponce de Leon Avenue, Second Floor City: San Juan City: SAN JUAN State: PR State: PR Zip: Zip: Last Updated: 5/14/2009 Legal Entity Name: MCS LIFE INSURANCE COMPANY Contract Number: H7981 Organization Marketing Name: MCS Classicare Parent Organization: Medical Card System, Inc. Organization Type: PFFS VP A- Medicare Compliance Plan Type: PFFS Name: Carlos J Fournier Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: MCS Plaza Legal Entity Address: 255 Ponce De Leon Ave, Suite Ponce de Leon Avenue, Second Floor City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 3/6/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 113 of 190
114 Legal Entity Name: MD CARE, INC. Contract Number: H7146 Organization Marketing Name: San Miguel Health Plan Parent Organization: MD Care, Inc. Contract Effective Date: 1/1/2008 CMS Region Responsible: San Francisco Enrollment: 877 Legal Entity Address: 100 West Broadway Suite 4000 City: Long Beach Zip: Legal Entity Name: MD CARE, INC. Contract Number: H7731 Organization Marketing Name: MD Care Inc Parent Organization: MD Care, Inc. Contract Effective Date: 1/1/2008 CMS Region Responsible: San Francisco Enrollment: 6,041 Legal Entity Address: Bloomfield Street Suite F City: Los Alamitos Zip: Legal Entity Name: MEDCORE HP Contract Number: H5811 Organization Marketing Name: Medcore HP Parent Organization: Medcore HP Contract Effective Date: 1/1/2006 CMS Region Responsible: San Francisco Enrollment: 2,060 Legal Entity Address: 2609 E. Hammer Lane City: Stockton Zip: Legal Entity Name: MEDICA HEALTH PLAN Contract Number: H7526 Organization Marketing Name: Medica Health Plans Parent Organization: Medica Health Plans Contract Effective Date: 1/1/2008 CMS Region Responsible: Chicago Enrollment: 475 Legal Entity Address: 401 Carlson Parkway City: Minnetonka State: MN Zip: Manager, Member Services Name: Angie Garcia Phone: [email protected] Address: Bloomfield Street Suite F City: Los Alamitos Zip: Last Updated: 12/11/2008 Director, Administrative Services Name: Gabriel Viola Phone: [email protected] Address: 1640 E Hill Street City: Signal Hill Zip: Last Updated: 5/12/2009 Customer Services Supervisor Name: Darlene Torres Phone: [email protected] Address: 2609 E. Hammer Lane City: Stockton Zip: Last Updated: 12/22/2008 Phone: [email protected] Address: 401 Carlson Parkway City: Minnetonka State: MN Zip: Last Updated: 4/23/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 114 of 190
115 Legal Entity Name: MEDICA HEALTH PLANS Contract Number: H2410 Organization Marketing Name: Medica Health Plans Parent Organization: Medica Health Plans Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 3,502 Address: 401 Carlson Parkway Legal Entity Address: 401 CARLSON PARKWAY City: Minnetonka City: MINNETONKA State: MN State: MN Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: MEDICA HEALTH PLANS Contract Number: H2458 Organization Marketing Name: Medica Health Plans Parent Organization: Medica Health Plans Contract Effective Date: 7/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: 8,466 Address: 401 Carlson Parkway Legal Entity Address: 401 Carlson Parkway City: Minnetonka City: MINNETONKA State: MN State: MN Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: MEDICA HEALTHCARE PLANS, INC. Contract Number: H5420 Organization Marketing Name: Medica HealthCare Plans, Inc. Parent Organization: Medica HealthCare Plans, Inc. Plan Type: PSO (State License) Name: Jenny Curbelo Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 15,850 Address: 4000 Ponce De Leon Blvd. Legal Entity Address: 4000 Ponce de Leon Blvd. Suite 650 Suite 650 City: Coral Gables City: CORAL GABLES State: FL State: FL Zip: Zip: Last Updated: 8/18/2006 Legal Entity Name: MEDICA INSURANCE COMPANY Contract Number: H2409 Organization Marketing Name: Medica Insurance Company Parent Organization: Medica Health Plans Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: Address: 401 Carlson Parkway Legal Entity Address: 401 CARLSON PARKWAY City: Minnetonka City: MINNETONKA State: MN State: MN Zip: Zip: Last Updated: 9/6/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 115 of 190
116 Legal Entity Name: MEDICA INSURANCE COMPANY Contract Number: H2450 Organization Marketing Name: Medica Insurance Company Parent Organization: Medica Health Plans Organization Type: 1876 Cost Plan Type: 1876 Cost Contract Effective Date: 1/1/1990 Phone: CMS Region Responsible: Chicago Enrollment: 70,041 Address: 401 Carlson Parkway Legal Entity Address: 401 Carlson Parkway P.O. BOX 9310 City: Minnetonka City: MINNEAPOLIS State: MN State: MN Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: MEDICAL ASSOCIATES CLINIC HEALTH PLAN Contract Number: H5256 Organization Marketing Name: Medical Associates Clinic Health Plan of Wisconsin Parent Organization: Medical Associates Clinic Organization Type: 1876 Cost Plan Type: 1876 Cost 2/1/1996 Marketing Specialist Name: Julie Hoffmann Phone: Contract Effective Date: CMS Region Responsible: Kansas City Enrollment: 2,565 Address: 1605 Associates Drive, Suite 101 Legal Entity Address: 1605 ASSOCIATES DRIVE, Suite 101 City: Dubuque City: DUBUQUE State: IA State: IA Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: MEDICAL ASSOCIATES HEALTH PLAN, INC. Contract Number: H1651 Organization Marketing Name: Medical Associates Health Plan, Inc. Parent Organization: Medical Associates Clinic Organization Type: 1876 Cost Plan Type: 1876 Cost Marketing Specialist Name: Julie Hoffmann Contract Effective Date: 2/1/1996 Phone: CMS Region Responsible: Kansas City Enrollment: 8,085 Address: 1605 Associates Drive Legal Entity Address: 1605 ASSOCIATES DRIVE City: Dubuque City: DUBUQUE State: IA State: IA Zip: Zip: Last Updated: 2/1/2007 Legal Entity Name: MEDICAL MUTUAL OF OHIO Contract Number: H4836 Organization Marketing Name: Advantage Plan from Medical Mutual of Ohio Parent Organization: MEDICAL MUTUAL OF OHIO Organization Type: PFFS Plan Type: PFFS Manager, Performance Group Call Center Name: Nancy Peebles Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 1,447 Address: 2060 East Ninth Street Legal Entity Address: 2060 East 9th Street City: Cleveland City: Cleveland State: OH State: OH Zip: Zip: Last Updated: 2/27/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 116 of 190
117 Legal Entity Name: MEDICAL MUTUAL OF OHIO Contract Number: H9313 Organization Marketing Name: Advantage Plans from Medical Mutual of Ohio Parent Organization: MEDICAL MUTUAL OF OHIO Manager, Performance Group Call Center Name: Nancy Peebles Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Chicago Enrollment: 2,497 Address: 2060 East Ninth Street Legal Entity Address: 2060 East Ninth Street City: Cleveland City: Cleveland State: OH State: OH Zip: Zip: Last Updated: 2/27/2009 Legal Entity Name: MENNONITE MUTUAL AID ASSOCIATION Contract Number: H8836 Organization Marketing Name: Mennonite Mutual Aid Association Parent Organization: Mennonite Mutual Aid Association Organization Type: RFB - PFFS Customer Service Manager Plan Type: RFB PFFS Name: Wendi Western Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] 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: Zip: Last Updated: 1/14/2009 Legal Entity Name: MERCY HEALTH PLANS Contract Number: H2611 Organization Marketing Name: Mercy Health Plans Parent Organization: Sisters of Mercy Health System-St. Louis. Director Customer Contact Centers Name: Ed Abrams Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Kansas City Enrollment: 3,137 [email protected] Address: S. Outer 40, Ste. 300 Legal Entity Address: S.OUTER 40, SUITE 300 City: Chesterfield City: CHESTERFIELD State: MO State: MO Zip: Zip: Last Updated: 12/12/2007 Legal Entity Name: MERCY HEALTH PLANS OF MISSOURI INC. Contract Number: H2667 Organization Marketing Name: Mercy Health Plans of Missouri, Inc. Parent Organization: Sisters of Mercy Health System-St. Louis. Director Customer Contact Centers Name: Ed Abrams Contract Effective Date: 2/1/1997 Phone: CMS Region Responsible: Kansas City Enrollment: 16,226 [email protected] Address: S. Outer 40, Ste. 300 Legal Entity Address: S.OUTER 40 ROAD SUITE 300 City: Chesterfield City: CHESTERFIELD State: MO State: MO Zip: Zip: Last Updated: 12/12/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 117 of 190
118 Legal Entity Name: METROPLUS HEALTH PLAN, INC. Contract Number: H0423 Organization Marketing Name: MetroPlus Health Plan Parent Organization: MetroPlus Health Plan, Inc. Director of Medicare Operations Name: Karen Eastmond Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 1,649 Address: 160 Water Street Legal Entity Address: 160 Water Street 3rd Floor 3rd Floor City: New York City: New York State: NY State: NY Zip: Zip: Last Updated: 5/8/2009 Legal Entity Name: METROPOLITAN HEALTH PLAN Contract Number: H2457 Organization Marketing Name: Metropolitan Health Plan MSHO Parent Organization: Metropolitan Health Plan Government Programs Manager Name: Susan Sommers Contract Effective Date: 1/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: Address: 400 South 4th Street Legal Entity Address: 400 South Fourth Street Suite 201 Suite 201 City: Minneapolis City: Minneapolis State: MN State: MN Zip: Zip: Last Updated: 10/14/2008 Legal Entity Name: METROPOLITAN HEALTH PLAN Contract Number: H5750 Organization Marketing Name: North Star Advantage / North Star Advantage Plus Parent Organization: Metropolitan Health Plan Government Programs Manager Name: Susan Sommers Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 400 South 4th Street Legal Entity Address: 400 South Fourth Street Suite 201 Suite 201 City: Minneapolis City: Minneapolis State: MN State: MN Zip: Zip: Last Updated: 10/14/2008 Legal Entity Name: MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION Contract Number: H2481 Organization Marketing Name: CareSource Parent Organization: Mid Rogue Community Health Plan Director of Marketing Name: Freddy Sennhauser Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Seattle Enrollment: 61 [email protected] Address: 740 SE 7th Street Legal Entity Address: 740 SE 7th Street City: Grants Pass City: Grants Pass State: OR State: OR Zip: Zip: Last Updated: 9/20/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 118 of 190
119 Legal Entity Name: MID ROGUE INDEPENDENT PHYSICIAN ASSOCIATION Contract Number: H3810 Organization Marketing Name: CareSource Parent Organization: Mid Rogue Community Health Plan Director of Marketing Name: Freddy Sennhauser Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 5,254 Address: 740 SE 7th Street Legal Entity Address: 740 SE 7th Street City: Grants Pass City: GRANTS PASS State: OR State: OR Zip: Zip: Last Updated: 9/20/2007 Legal Entity Name: MIDLAND CARE CONNECTION Contract Number: H5822 Organization Marketing Name: Midland PACE Parent Organization: MIDLAND HOSPICE, INC. Organization Type: National PACE Plan Type: National PACE 1/1/2007 CMS Region Responsible: Kansas City Enrollment: 51 IT Coordinator Name: Dreux Doty Phone: Address: 200 SW Frazier Circle Contract Effective Date: Legal Entity Address: 200 SW Frazier Circle City: Topeka City: Topeka State: KS State: KS Zip: Zip: Last Updated: 10/25/2006 Legal Entity Name: MIDWEST HEALTH PLAN, INC. Contract Number: H5685 Organization Marketing Name: Midwest Advantage Parent Organization: Midwest Health Plan, Inc. DIRECTOR OF CUSTOMER SERVICES Name: Pat Vier Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: Address: 5050 SCHAEFER ROAD Legal Entity Address: 5050 Schaefer Road City: DEARBORN City: Dearborn State: MI State: MI Zip: Zip: Last Updated: 3/26/2009 Legal Entity Name: MMM HEALTHCARE, INC. Contract Number: H4003 Organization Marketing Name: Medicare y Mucho Mßs Parent Organization: Aveta, LLC. Provider AVP Name: Brenda Rivera Phone: Contract Effective Date: 9/1/ CMS Region Responsible: New York Enrollment: 129,381 [email protected] Address: 350 Avenida Chard n Legal Entity Address: 350 Chardon Ave Suite 500 Torre Chard n, Suite 500 Torre Chardon City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 5/9/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 119 of 190
120 Legal Entity Name: MOLINA HEALTHCARE OF CALIFORNIA Contract Number: H5810 Organization Marketing Name: Molina Healthcare of California Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 1,612 [email protected] Address: 200 Oceangate Legal Entity Address: 200 Oceangate Suite 100 Ste. 100 City: Long Beach City: Long Beach Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: MOLINA HEALTHCARE OF MICHIGAN Contract Number: H5926 Organization Marketing Name: Molina Healthcare of Michigan Parent Organization: Molina Healthcare, Inc., 1/1/2006 Vice President Name: Richard G Slaughter Phone: Contract Effective Date: CMS Region Responsible: Denver Enrollment: 2,036 [email protected] Address: 200 Oceangate Legal Entity Address: 100 W. Big Beaver Ste. 100 Suite 600 City: Long Beach City: Troy State: MI Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: MOLINA HEALTHCARE OF NEVADA, INC. Contract Number: H5588 Organization Marketing Name: Molina Healthcare of Nevada Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 200 Oceangate Legal Entity Address: 7050 S. Union Park Center, Suite 200 Ste. 100 City: Long Beach City: Midvale State: UT Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: MOLINA HEALTHCARE OF NEW MEXICO, INC. Contract Number: H9082 Organization Marketing Name: Molina Healthcare of New Mexico, Inc. Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 200 Oceangate Legal Entity Address: 8801 Horizons Blvd., Suite 400 Ste. 100 City: Long Beach City: Albuquerque State: NM Zip: Zip: Last Updated: 2/19/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 120 of 190
121 Legal Entity Name: MOLINA HEALTHCARE OF OHIO Contract Number: H0490 Organization Marketing Name: Molina Healthcare of Ohio Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Denver Enrollment: 13 [email protected] Address: 200 Oceangate Legal Entity Address: 8101 NORTH HIGH STREET SUITE 180 Ste. 100 City: Long Beach City: COLUMBUS State: OH Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: MOLINA HEALTHCARE OF TEXAS, INC. Contract Number: H7678 Organization Marketing Name: Molina Healthcare of Texas, Inc. Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 200 Oceangate Legal Entity Address: 2505 North Hwy 360, Suite 300 Ste. 100 City: Long Beach City: Grand Prairie State: TX Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: MOLINA HEALTHCARE OF UTAH, INC. Contract Number: H5628 Organization Marketing Name: Molina Healthcare of Utah Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 3,038 [email protected] Address: 200 Oceangate Legal Entity Address: 7050 Union Park Center Ste. 100 Suite 200 City: Long Beach City: Midvale State: UT Zip: Zip: Last Updated: 2/19/2008 Legal Entity Name: MOLINA HEALTHCARE OF WASHINGTON, INC. Contract Number: H5823 Organization Marketing Name: Molina Healthcare of Washington, Inc. Parent Organization: Molina Healthcare, Inc., Vice President Name: Richard G Slaughter Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 200 Oceangate Legal Entity Address: th Dr. SE Ste. 100 Suite 400 City: Long Beach City: Bothell State: WA Zip: Zip: Last Updated: 2/19/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 121 of 190
122 Legal Entity Name: MOUNT CARMEL HEALTH INSURANCE COMPANY Contract Number: H1846 Organization Marketing Name: MediGold Parent Organization: Trinity Health Provider Relations Call Center Name: Provider Call Center Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Chicago Enrollment: Address: 6150 E. Broad St, EE320 Legal Entity Address: 6150 E. Broad St. EE320 City: Columbus City: Columbus State: OH State: OH Zip: Zip: Last Updated: 2/28/2008 Legal Entity Name: MOUNTAIN EMPIRE OLDER CITIZENS, INCX. Contract Number: H5037 Organization Marketing Name: Mountain Empire PACE Parent Organization: Mountain Empire Older Citizens, Inc Organization Type: National PACE Plan Type: National PACE Name: Tony Lawson Contract Effective Date: 3/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: 43 Address: P. O. Box 888 Legal Entity Address: 1501 Third Avenue East P.O. Box 888 City: Big Stone Gap VA City: Big Stone Gap State: VA Zip: Last Updated: State: Zip: 4/23/2009 Legal Entity Name: MT. CARMEL HEALTH PLAN, INC. Contract Number: H3668 Organization Marketing Name: MediGold Parent Organization: Trinity Health Provider Relations Call Center Name: Provider Call Center Contract Effective Date: 3/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: 27,484 Address: 6150 E. Broad St, EE320 Legal Entity Address: 6150 East Broad Street, EE320 City: Columbus City: Columbus State: OH State: OH Zip: Zip: Last Updated: 10/24/2007 Legal Entity Name: MVP HEALTH PLAN, INC, Contract Number: H9859 Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP HEALTH PLAN, INC. Sales Manager Medicare Name: Catherine Mercury Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 6,559 Address: 220 Alexander St Legal Entity Address: 625 State Street City: Rochester City: Schenectady State: NY State: NY Zip: Zip: Last Updated: 5/18/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 122 of 190
123 Legal Entity Name: MVP HEALTH PLAN, INC. Contract Number: H3305 Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP Health Care, Inc. Sales Manager, Medicare Name: Catherine Mercury Contract Effective Date: 11/1/1985 Phone: CMS Region Responsible: New York Enrollment: 70,677 Address: 220 Alexander St Legal Entity Address: 220 Alexander Ave. City: Rochester City: Rochester State: NY State: NY Zip: Zip: Last Updated: 5/18/2009 Legal Entity Name: MVP HEALTH PLAN, INC. Contract Number: H3346 Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP Health Care, Inc. Sales Manager Medicare Name: Catherine Mercury Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: New York Enrollment: 1,333 Address: 220 Alexander St Legal Entity Address: 220 Alexander St. City: Rochester City: ROCHESTER State: NY State: NY Zip: Zip: Last Updated: 5/18/2009 Legal Entity Name: MVP HEALTH PLAN, INC. Contract Number: H6806 Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP Health Care, Inc. Organization Type: PFFS Sales Manager Medicare Plan Type: PFFS Name: Catherine Mercury Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: New York Enrollment: 16,789 Address: 220 Alexander St Legal Entity Address: 220 Alexander St. City: Rochester City: Rochester State: NY State: NY Zip: Zip: Last Updated: 5/18/2009 Legal Entity Name: MVP HEALTH PLAN, INC. Contract Number: H9615 Organization Marketing Name: MVP HEALTH CARE Parent Organization: MVP HEALTH PLAN, INC. Sales Manager Medicare Name: Catherine Mercury Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: New York Enrollment: 1,103 Address: 220 Alexander St Legal Entity Address: 625 State Street City: Rochester City: Schenectady State: NY State: NY Zip: Zip: Last Updated: 5/18/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 123 of 190
124 Legal Entity Name: NATIONAL HEALTH PLAN NETWORK INC. Contract Number: H3338 Organization Marketing Name: National Health Plan Network Inc. Parent Organization: National Health Plan Network Inc Organization Type: HCPP Cost Plan Type: HCPP Cost Contract Effective Date: 7/1/2005 CMS Region Responsible: New York Enrollment: 178 Legal Entity Address: 11 PENN PLAZA SUITE 330 City: NEW YORK State: NY Zip: Legal Entity Name: NEIGHBORHOOD HEALTH PROVIDERS LLC Contract Number: H3336 Organization Marketing Name: Neighborhood Health Providers Parent Organization: Brookdale University and Hospital 1/1/2005 No contact data submitted Name: Phone: Address: City: State: Zip: Last Updated: Vice President Name: Audrey Brahamsha Phone: Contract Effective Date: CMS Region Responsible: New York Enrollment: 2,977 [email protected] Address: 521 5th Avenue Legal Entity Address: 521 FIFTH AVENUE, THIRD FLOOR Third Floor City: New York State: NY Zip: Last Updated: City: NEW YORK State: NY Zip: /11/2007 Legal Entity Name: NETWORK HEALTH INSURANCE CORPORATION Contract Number: H5215 Organization Marketing Name: Network Health Insurance Corp. MA Plans Parent Organization: Affinity Health System VP Medicare Products Name: Marcia Broeren Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 19,910 [email protected] Address: 1570 Midway Place Legal Entity Address: 1570 MIDWAY PLACE P.O. Box 120 P.O. Box 120 City: Menasha City: MENASHA State: WI State: WI Zip: Zip: Last Updated: 3/24/2008 Legal Entity Name: NEW WEST HEALTH SERVICES Contract Number: H2701 Organization Marketing Name: New West Health Services Parent Organization: New West Health Services Director of Government Programs Name: Bonnie Franklin Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: Denver Enrollment: 2,885 [email protected] Address: 1203 Highway 2 West, Suite 45 Legal Entity Address: 130 NEILL AVE City: Kalispell City: HELENA State: MT State: MT Zip: Zip: Last Updated: 3/26/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 124 of 190
125 Legal Entity Name: NEW YORK STATE CATHOLIC HLTH PLAN INC Contract Number: H3328 Organization Marketing Name: Fidelis Care Parent Organization: The New York State Catholic Health Plan, Inc. Name: Adrian Gardner Contract Effective Date: 5/1/2004 Phone: CMS Region Responsible: New York Enrollment: 4,713 Address: Queens Boulevard Legal Entity Address: QUEENS BOULEVARD City: Rego Park City: REGO PARK State: NY State: NY Zip: Zip: Last Updated: 8/22/2006 Legal Entity Name: NHP OF INDIANA, LLC Contract Number: H3044 Organization Marketing Name: Welborn Health Plans Parent Organization: Welborn Clinic 1/1/2008 Medicare Product Manager Name: David Marx Phone: Contract Effective Date: CMS Region Responsible: Chicago Enrollment: 1,763 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 State: NY Zip: Zip: Last Updated: 1/21/2009 Legal Entity Name: NORTHLAND PACE PROGRAM Contract Number: H7195 Organization Marketing Name: Northland PACE Program Parent Organization: Northland Healthcare Alliance Organization Type: National PACE Plan Type: National PACE Name: Laurie Peters Contract Effective Date: 8/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 16 Address: 201 North 24th Street Legal Entity Address: 201 North 24th Street City: Bismarck City: Bismarck State: ND State: ND Zip: Zip: Last Updated: 5/18/2009 Legal Entity Name: NY HOTEL TRADES COUNCIL and HOTEL ASSN OF NYC Contract Number: H6334 Organization Marketing Name: NY Hotel Trades Council and Hotel Assn. of NYC Parent Organization: NY Hotel Trades Council&Hotel Assn of NYC Organization Type:HCPP Cost Compliance Officer, Government Programs Plan Type:HCPP Cost Name: Jordan Beasley Contract Effective Date:1/1/1987 Phone: Tax Status:Not-for-Profit/Non-Profit CMS Region Responsible:New York Enrollment:3,816 [email protected] Address: 305 West 44th Street Legal Entity Address: 305 WEST 44TH STREET City:New York City:NEW YORK State:NY State:NY Zip:11101 Zip:10036 Last Updated: 12/27/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 125 of 190
126 Legal Entity Name: ODS HEALTH PLAN, INC. Contract Number: H3813 Organization Marketing Name: ODS Health Plan, Inc. Parent Organization: The ODS Companies (ODS) ODS Advantage Member Services Name: Member Services Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 6,113 Address: 601 S.W. Second Ave. Legal Entity Address: 601 SW Second Avenue City: Portland City: Portland State: OR State: OR Zip: Zip: Last Updated: 5/21/2008 Legal Entity Name: ON LOK SENIOR HEALTH SERVICES Contract Number: H5403 Organization Marketing Name: On Lok Lifeways Parent Organization: On Lok Senior Health Services Organization Type: National PACE Information and Referral Specialist Plan Type: National PACE Name: Norine Bell Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 1333 Bush St. Legal Entity Address: 1333 BUSH STREET City: San Francisco City: SAN FRANCISCO Zip: Zip: Last Updated: 8/18/2006 Legal Entity Name: OPTIMA HEALTH INSURANCE COMPANY Contract Number: H4908 Organization Marketing Name: Optima Medicare Parent Organization: Sentara Healthcare Director, Customer Service Name: Ydsia N Slagle Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: 4,505 [email protected] Address: 4417 Corporation Lane Legal Entity Address: 4417 CORPORATION LANE City: Virginia Beach City: VIRGINIA BEACH State: VA State: VA Zip: Zip: Last Updated: 8/23/2006 Legal Entity Name: OPTIMUM HEALTHCARE, INC. Contract Number: H5594 Organization Marketing Name: Optimum HealthCare, Inc. Parent Organization: Optimum HealthCare, Inc. Director, Sales Operations Name: Robin Florez Phone: [email protected] Address: 5403, Church Ave N, Contract Effective Date: 1/1/ CMS Region Responsible: Atlanta Enrollment: 4,533 Legal Entity Address: 5403 N. Church Ave City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 10/31/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 126 of 190
127 Legal Entity Name: ORANGE COUNTY HEALTH AUTHORITY Contract Number: H5433 Organization Marketing Name: OneCare Parent Organization: CalOptima Name: OneCare Customer Service Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 8,869 Address: 1120 W. La Veta Avenue Legal Entity Address: 1120 WEST LA VETA AVENUE, 5TH FLOOR City: Orange City: ORANGE Zip: Zip: Last Updated: 9/6/2006 Legal Entity Name: OSF HEALTHPLANS, INC. Contract Number: H1468 Organization Marketing Name: Humana Benefit Plan of Illinois, Inc. Parent Organization: Humana Inc. Contract Effective Date: 2/1/1999 Phone: CMS Region Responsible: Kansas City Enrollment: 1,050 Address: 101 East Main Street Legal Entity Address: 201 West Main Street City: Louisville City: Louisville State: KY State: KY Zip: Zip: Last Updated: 7/3/2008 Legal Entity Name: OSF HEALTHPLANS, INC. Contract Number: H5525 Organization Marketing Name: Humana Benefit Plan of Illinois, Inc. Parent Organization: Humana Inc. Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Kansas City Enrollment: 14,576 Address: 101 East Main Street Legal Entity Address: 1100 Employers Boulevard City: Louisville City: DePere State: KY State: WI Zip: Zip: Last Updated: 7/3/2008 Legal Entity Name: OXFORD HEALTH PLANS (CT), INC. Contract Number: H0752 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 10/1/1995 Phone: CMS Region Responsible: San Francisco Enrollment: 1,608 Address: 5757 Plaza Dr Legal Entity Address: 48 MONROE TURNPIKE CA City: Cyress City: TRUMBULL State: CT Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 127 of 190
128 Legal Entity Name: OXFORD HEALTH PLANS (NJ), INC. Contract Number: H3107 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 10/1/1991 Phone: CMS Region Responsible: San Francisco Enrollment: 23,420 Address: 5757 Plaza Dr Legal Entity Address: 48 Monroe Turnpike CA City: Cyress Zip: City: Trumbull State: CT Zip: Last Updated: 4/14/2009 Legal Entity Name: OXFORD HEALTH PLANS (NJ), INC. Contract Number: H3113 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 44 SOUTH BROADWAY CA City: Cyress City: WHITE PLAINS State: NY Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: OXFORD HEALTH PLANS (NY), INC. Contract Number: H3307 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 10/1/1991 Phone: CMS Region Responsible: San Francisco Enrollment: 70,094 Address: 5757 Plaza Dr Legal Entity Address: 48 Monroe Turnpike City: Trumbull CA City: Cyress State: CT Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: PACE GREATER NEW ORLEANS Contract Number: H1904 Organization Marketing Name: Pace Greater New Orleans Parent Organization: PACE GREATER NEW ORLEANS Organization Type: National PACE Plan Type: National PACE Director of Finance Name: Christophe K Meguess Contract Effective Date: 9/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 57 [email protected] Address: 4201 N RAMPART ST Legal Entity Address: 4201 N. Rampart Street City: NEW ORLEANS City: ORLEANS State: LA State: LA Zip: Zip: Last Updated: 5/23/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 128 of 190
129 Legal Entity Name: PACE ORGANIZATION OF RHODE ISLAND Contract Number: H4105 Organization Marketing Name: Pace Organization Of Rhode Island Parent Organization: PACE Organization of Rhode Island Organization Type: National PACE Plan Type: National PACE CEO Name: Joan L Kwiatkowski Contract Effective Date: 12/1/2005 Phone: CMS Region Responsible: Boston Enrollment: [email protected] Address: 225 Chapman Street, Box 7 Legal Entity Address: 225 CHAPMAN STREET City: Providence City: PROVIDENCE State: RI State: RI Zip: Zip: Last Updated: 4/16/2009 Legal Entity Name: PACE VERMONT, INC. Contract Number: H0346 Organization Marketing Name: PACE Vermont, Inc Parent Organization: PACE VERMONT, INC. Organization Type: National PACE Administrative & Fiscal Service Manager Plan Type: National PACE Name: Patricia Gratton Contract Effective Date: 3/1/2007 Phone: CMS Region Responsible: Boston Enrollment: 57 [email protected] Address: 786 College Parkwary Legal Entity Address: 786 College Parkway City: Colchester City: Colchester State: VT State: VT Zip: Zip: Last Updated: 5/29/2007 Legal Entity Name: PACIFICARE OF ARIZONA, INC Contract Number: H0303 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 4/1/1986 Phone: CMS Region Responsible: San Francisco Enrollment: 94,599 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 410 NORTH 44TH STREET CA PO BOX City: Cyress City: PHOENIX State: AZ Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: PACIFICARE OF CALIFORNIA/SECURE HORIZONS Contract Number: H0543 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 6/1/1985 Phone: CMS Region Responsible: San Francisco Enrollment: 327,954 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 5995 PLAZA DRIVE CA City: Cyress City: CYPRESS Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 129 of 190
130 Legal Entity Name: PACIFICARE OF COLORADO, INC Contract Number: H0609 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 7/1/1986 Phone: CMS Region Responsible: San Francisco Enrollment: 62,435 Address: 5757 Plaza Dr Legal Entity Address: 6455 YOSEMITE STREET CA City: Cyress Zip: City: GREENWOOD VILLAG State: CO Zip: Last Updated: 4/14/2009 Legal Entity Name: PACIFICARE OF NEVADA, INC. Contract Number: H7949 Organization Marketing Name: Pacificare/UHC of Nevada Name: Richard Irwin Contract Effective Date: 5/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: 1,160 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Rd E CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: PACIFICARE OF OKLAHOMA, INC. Contract Number: H3749 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/1991 Phone: CMS Region Responsible: San Francisco Enrollment: 21,025 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 7666 E 61ST, #500 CA City: Cyress City: TULSA State: OK Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: PACIFICARE OF OREGON, INC. Contract Number: H3805 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/1986 Phone: CMS Region Responsible: San Francisco Enrollment: 19,752 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 7525 S.E. 24TH STREET CA City: Cyress City: MERCER ISLAND State: WA Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 130 of 190
131 Legal Entity Name: PACIFICARE OF TEXAS, INC. Contract Number: H4590 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 11/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 133,628 Address: 5757 Plaza Dr Legal Entity Address: 8200 IH-10 CA SUITE 1000 City: Cyress City: SAN ANTONIO State: TX Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: PACIFICARE OF WASHINGTON, INC. Contract Number: H5005 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 3/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 35,631 Address: 5757 Plaza Dr Legal Entity Address: 7525 S.E. 24TH STREET CA City: Cyress City: MERCER ISLAND State: WA Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: PALMETTO HEALTH ALLIANCE Contract Number: H4203 Organization Marketing Name: Palmetto SeniorCare Parent Organization: Palmetto Health Alliance Organization Type: National PACE Plan Type: National PACE Administrative Coordinator Intake Name: Shirley Gregg Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: Atlanta Enrollment: Address: 1308 Laureo Street Legal Entity Address: 15 RICHLAND MEDICAL PARK DRIVE SUITE 203 City: Columbia City: COLUMBIA State: SC State: SC Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: PAN AMERICAN LIFE INSURANCE CO. OF PUERTO RICO INC Contract Number: H3195 Organization Marketing Name: PALIC Medicare Parent Organization: Pan American Life Insurance Company Project Manager Name: Janice Albert Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: New York Enrollment: Address: PO BOX Legal Entity Address: Metro Office Park 2 Calle 1 Suite 101 City: San Juan City: Guaynabo State: PR State: PR Zip: Zip: Last Updated: 1/31/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 131 of 190
132 Legal Entity Name: PAN AMERICAN LIFE INSURANCE COMPANY OF PUERTO RICO Contract Number: H5270 Organization Marketing Name: PALIC Medicare Parent Organization: Pan American Life Insurance Company Project Manager Name: Janice Albert Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: PO BOX Legal Entity Address: Metro Office Park 2 Calle 1 Suite 101 Calle 1 Suite 101 City: San Juan City: Guaynabo State: PR State: PR Zip: Zip: Last Updated: 1/31/2008 Legal Entity Name: PARAMOUNT CARE, INC Contract Number: H3653 Organization Marketing Name: Paramount Elite Parent Organization: Promedica Health System Member Services Dept. Name: Customer Representative Contract Effective Date: 2/1/1995 Phone: CMS Region Responsible: Chicago Enrollment: 14,843 [email protected] Address: 1901 Indian Wood Circle Legal Entity Address: 1901 INDIAN WOOD CIRCLE City: Maumee City: Maumee State: OH State: OH Zip: Zip: Last Updated: 8/11/2008 Legal Entity Name: PARTNERS NATIONAL HEALTH PLANS OF NC INC Contract Number: H3404 Organization Marketing Name: PARTNERS National Health Plans, a BCBSNC company Parent Organization: Blue Cross and Blue Shield of North Carolina Call Center support Name: Provider Services Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 5,758 [email protected] Address: 5660 University Pkwy Legal Entity Address: 5660 University Parkway City: Winston Salem City: WINSTON-SALEM State: NC State: NC Zip: Zip: Last Updated: 2/5/2009 Legal Entity Name: PARTNERS NATIONAL HEALTH PLANS OF NC, INC. Contract Number: H3449 Organization Marketing Name: PARTNERS National Health Plans, a BCBSNC company Parent Organization: Blue Cross and Blue Shield of North Carolina Call Center support Name: Provider Services Contract Effective Date: 7/1/1995 Phone: CMS Region Responsible: Atlanta Enrollment: 40,254 [email protected] Address: 5660 University Pkwy Legal Entity Address: 5660 University Parkway City: Winston Salem City: WINSTON-SALEM State: NC State: NC Zip: Zip: Last Updated: 2/5/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 132 of 190
133 Legal Entity Name: PARTNERSHIP HEALTH PLAN, INC. Contract Number: H5206 Organization Marketing Name: Community Health Partnership Parent Organization: Community Health Partnership, Inc. Claims Specialist Name: Priscilla Koxlien Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: Chicago Enrollment: 1,655 Address: 2240 EastRidge Center Legal Entity Address: 2240 EASTRIDGE CENTER City: Eau Claire City: EAU CLAIRE State: WI State: WI Zip: Zip: Last Updated: 5/19/2008 Legal Entity Name: PARTNERSHIP HEALTHPLAN OF CALIFORNIA Contract Number: H5782 Organization Marketing Name: Partnership HealthPlan of California Parent Organization: PARTNERSHIP HEALTHPLAN OF CALIFORNIA 1/1/2007 Data Entry and Enrollment Unit Coordinator Name: Lisa Harrison Phone: Contract Effective Date: CMS Region Responsible: San Francisco Enrollment: 3,480 Address: 360 Campus Lane, Suite 100 Legal Entity Address: 360 Campus Lane Suite 100 City: Fairfield CA City: Fairfield Zip: Last Updated: State: Zip: 8/4/2008 Legal Entity Name: PENNSYLVANIA LIFE INSURANCE COMPANY Contract Number: H5301 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Organization Type: Demo Plan Type: ESRD I - PFFS Member Service Representative Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: [email protected] Address: 4888 Loop Central Drive Legal Entity Address: c/o HHS Texas Management Suite Loop Central Drive, Suite 800 City: Houston City: Houston State: TX State: TX Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: PENNSYLVANIA PACE, INC. Contract Number: H3925 Organization Marketing Name: Senior LIFE Johnstown Parent Organization: Pennsylvania PACE, Inc. Organization Type: National PACE Plan Type: National PACE Cheif Executive Officer Name: Mark Irwin Phone: Contract Effective Date: 11/1/ CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: 401 Broad Street Legal Entity Address: 209 Sigma Drive City: Johnstown City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 5/16/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 133 of 190
134 Legal Entity Name: PEOPLES HEALTH, INC. Contract Number: H1961 Organization Marketing Name: Peoples Health Parent Organization: Tenet Healthcare Corporation Name: Member Services Contract Effective Date: 7/1/1997 Phone: CMS Region Responsible: Dallas Enrollment: 42,221 [email protected] Address: Three Lakeway Center Legal Entity Address: Three Lakeway Center 3838 N Causeway Blvd, Suite N Causeway Blvd., Suite 2200 City: Metairie City: Metairie State: LA State: LA Zip: Zip: Last Updated: 9/15/2006 Legal Entity Name: PEOPLES HEALTH, INC. Contract Number: H5501 Organization Marketing Name: Peoples Health Parent Organization: Tenet Healthcare Corporation Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Dallas Enrollment: [email protected] Address: Three Lakeway Center Legal Entity Address: Three Lakeway Center 3838 N Causeway Blvd, Suite N Causeway Blvd., Suite 2200 City: Metairie City: Metairie State: LA State: LA Zip: Zip: Last Updated: 9/20/2006 Legal Entity Name: PERSONAL CARE INSURANCE OF ILLINOIS Contract Number: H7301 Organization Marketing Name: PersonalCare Advantra Parent Organization: Coventry Health Care Inc. Director, Medicare/Individual Name: Carol A Baker Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 1,189 [email protected] Address: 2110 Fox Dr Legal Entity Address: 2110 Fox Drive, Ste. A City: Champaign City: Champaign State: IL State: IL Zip: Zip: Last Updated: 3/5/2007 Legal Entity Name: PHI LIFE Contract Number: H5978 Organization Marketing Name: PHI LIFE dba everyday LIFE Parent Organization: PHI LIFE Organization Type: National PACE Plan Type: National PACE Executive Director Name: Wendy Weaver Contract Effective Date: 2/1/2009 Phone: CMS Region Responsible: Philadelphia Enrollment: * [email protected] Address: 2045 Westgate Dr. Legal Entity Address: One Trinity Dr. East Suite 100 Suite 201 City: Bethlehem City: Dillsburg State: PA State: PA Zip: Zip: Last Updated: 12/18/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 134 of 190
135 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF ARKANSAS Contract Number: H7252 Organization Marketing Name: Physicians Health Choice Parent Organization: PSO Health Services, LLC Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 FREDERICKBURG ROAD SUITE 360 City: San Antonio City: SAN ANTONIO State: TX State: TX Zip: Zip: Last Updated: 8/18/2008 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF FLORIDA Contract Number: H6120 Organization Marketing Name: PHYSICIANS HEALTH CHOICE Parent Organization: PSO Health Services, LLC Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: 30 Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 FREDERICKSBURG ROAD SUITE 360 City: San Antonio City: SAN ANTONIO State: TX State: TX Zip: Zip: Last Updated: 8/18/2008 Legal Entity Name: PHYSICIANS HEALTH CHOICE OF NEW MEXICO Contract Number: H3059 Organization Marketing Name: PHYSICIANS HEALTH CHOICE OF NEW MEXICO Parent Organization: PSO Health Services, LLC Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 1,053 Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 Fredericksburg Road Suite 360 City: San Antonio City: San Antonio State: TX State: TX Zip: Zip: Last Updated: 8/14/2008 Legal Entity Name: PHYSICIANS UNITED PLAN, INC. Contract Number: H5696 Organization Marketing Name: PUP Parent Organization: Physician's United Plan, Inc. Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Atlanta Enrollment: 17,567 Address: 6220 S. Orange Blossom Trail Legal Entity Address: 483 North Semoran Boulevard City: Orlando City: Winter Park State: FL State: FL Zip: Zip: Last Updated: 1/4/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 135 of 190
136 Legal Entity Name: PIEDMONT HEALTH SERVICES, INC. Contract Number: H9266 Organization Marketing Name: Piedmont Health SeniorCare Parent Organization: PIEDMONT HEALTH SERVICES, INC. Organization Type: National PACE Plan Type: National PACE Executive Director, Piedmont Health SeniorCare Name: Marianne C Ratcliffe Contract Effective Date: 10/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 23 [email protected] Address: 1214 Vaughn Road Legal Entity Address: 1214 Vaughn Road City: Burlington City: Burlington State: NC State: NC Zip: Zip: Last Updated: 9/9/2008 Legal Entity Name: PITTSBURGH CARE PARTNERSHIP, INC. Contract Number: H3917 Organization Marketing Name: Community LIFE Parent Organization: Pittsburgh Care Partnership, Inc. Organization Type: National PACE Plan Type: National PACE 3/1/2004 OUTREACH COORDINATOR Name: STACI KACZKOWSKI Phone: Contract Effective Date: CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: SUITE # 700 Legal Entity Address: 2400 ARDMORE BOULEVARD, SUITE 700 City: PITTSBURGH State: PA ARDMORE BOULEVARD City: PITTSBURGH State: PA Zip: Last Updated: Zip: /13/2007 Legal Entity Name: PREFERRED CARE PARTNERS INC. Contract Number: H1045 Organization Marketing Name: Preferred Care Partners, Inc. Parent Organization: Preferred Care Partners Holding Corporation Name: Arlen Delgado Contract Effective Date: 8/1/2002 Phone: CMS Region Responsible: Atlanta Enrollment: 20,770 [email protected] Address: 9100 South Dadeland Blvd Legal Entity Address: 9100 SOUTH DADELAND BLVD. Suite 1250 SUITE 1250 City: Miami City: MIAMI State: FL State: FL Zip: Zip: Last Updated: 11/25/2008 Legal Entity Name: PREFERRED MEDICARE CHOICE, INC. Contract Number: H4004 Organization Marketing Name: Preferred Medicare Choice, Inc. Parent Organization: Aveta, LLC. Provider AVP Name: Brenda J Rivera Phone: Contract Effective Date: 8/1/ CMS Region Responsible: New York Enrollment: 52,367 [email protected] Address: 350 Avenida Chard n Legal Entity Address: 350 Chard n Avenue Torre Chard n, Suite 500 Suite 500, Torre Chard n City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 5/9/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 136 of 190
137 Legal Entity Name: PRESBYTERIAN HEALTH PLAN Contract Number: H3204 Organization Marketing Name: Presbyterian Senior Care Parent Organization: Presbyterian Healthcare Services VP - Government Programs Name: Mary Eden Contract Effective Date: 4/1/1986 Phone: CMS Region Responsible: Dallas Enrollment: 20,756 [email protected] Address: P.O. Box Legal Entity Address: 2501 BUENA VISTA SE P.O. BOX City: Albuquerque City: ALBUQUERQUE State: NM State: NM Zip: Zip: Last Updated: 4/6/2009 Legal Entity Name: PRESBYTERIAN INSURANCE COMPANY, INC. Contract Number: H3206 Organization Marketing Name: Presbyterian MediCare PPO Parent Organization: Presbyterian Healthcare Services 7/1/2005 CMS Region Responsible: Dallas Enrollment: 4,185 VP - Government Programs Name: Mary Eden Phone: [email protected] Address: P.O. Box Contract Effective Date: Legal Entity Address: P.O. BOX BUENA VISTA, S.E. City: Albuquerque City: ALBUQUERQUE State: NM State: NM Zip: Zip: Last Updated: 4/6/2009 Legal Entity Name: PRIMEWEST HEALTH SYSTEM Contract Number: H2416 Organization Marketing Name: PrimeWest Health Parent Organization: PrimeWest Health System Director of Member and Enrollment Services Name: Pauletta J Gesch Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 2,067 [email protected] Address: 2209 Jefferson Street Legal Entity Address: 2209 Jefferson Street Suite 101 Suite 101 City: Alexandria City: ALEXANDRIA State: MN State: MN Zip: Zip: Last Updated: 12/3/2007 Legal Entity Name: PRIMEWEST HEALTH SYSTEM Contract Number: H2926 Organization Marketing Name: PrimeWest Health Parent Organization: PrimeWest Health System Director, Marketing & Communications Name: Beth Hendrickson Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: PrimeWest Health System Legal Entity Address: 2209 Jefferson Street 2209 Jefferson Street, Suite 101 Suite 101 City: Alexandria City: Alexandria State: MN State: MN Zip: Zip: Last Updated: 2/13/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 137 of 190
138 Legal Entity Name: PRIORITY HEALTH Contract Number: H1326 Organization Marketing Name: PriorityMedicarePFFS Parent Organization: Spectrum Health System Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Chicago Enrollment: * CS [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: Zip: Last Updated: 1/31/2008 Legal Entity Name: PRIORITY HEALTH Contract Number: H2320 Organization Marketing Name: PriorityMedicare Parent Organization: Spectrum Health System Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 16,006 CS [email protected] Address: 1231 East Beltline Ave NE Legal Entity Address: 1231 EAST BELTLINE AVE N.E. City: Grand Rapids City: GRAND RAPIDS State: MI State: MI Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: PROSALUD HMO CORPORATION Contract Number: H0046 Organization Marketing Name: ProSalud Medicare Esencial Activo Parent Organization: Jaahel Group, Inc. System Information Manager Name: Emmanuel Morales Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: New York Enrollment: [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: Zip: Last Updated: 2/8/2008 Legal Entity Name: PROSALUD HMO, CORP. Contract Number: H2291 Organization Marketing Name: ProSalud HMO Corp Parent Organization: Jaahel Group, Inc. System Information Manager Name: Emmanuel Morales Phone: [email protected] Address: Suite 232, 85 De Diego Avenue Contract Effective Date: 1/1/ CMS Region Responsible: New York Enrollment: 152 Legal Entity Address: Suite 232, 85 De Diego Avenue City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 3/28/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 138 of 190
139 Legal Entity Name: PROVIDENCE HEALTH PLAN Contract Number: H9047 Organization Marketing Name: Providence Health Plan Parent Organization: Providence Health System Medicare Compliance Coordinator Name: Keri Steege Contract Effective Date: 12/1/1985 Phone: CMS Region Responsible: Seattle Enrollment: 35,644 Address: 3601 SW Murray Blvd. Legal Entity Address: 3601 SW MURRAY BLVD. Suite 10 SUITE 10 City: Beaverton City: BEAVERTON State: OR State: OR Zip: Zip: Last Updated: 8/16/2006 Legal Entity Name: PROVIDENCE HEALTH SYSTEM Contract Number: H5007 Organization Marketing Name: Providence Health System Parent Organization: Providence Health System Organization Type: National PACE Plan Type: National PACE 11/1/2002 Compliance & Special Projects Coordinator Name: Susan Hayashida Phone: Contract Effective Date: CMS Region Responsible: Seattle Enrollment: 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: Zip: Last Updated: 5/24/2007 Legal Entity Name: PROVIDENCE HEALTH SYSTEM - OREGON Contract Number: H3809 Organization Marketing Name: Providence ElderPlace Portland Parent Organization: Providence Health System Organization Type: National PACE Plan Type: National PACE Name: Rika Bering Contract Effective Date: 11/1/2003 Phone: CMS Region Responsible: Seattle Enrollment: [email protected] Address: 4531 SE Belmont Legal Entity Address: 4531 SE Belmont Suite 100 Suite 100 City: Portland City: PORTLAND State: OR State: OR Zip: Zip: Last Updated: 8/19/2008 Legal Entity Name: PSO HEALTH SERVICES, LLC Contract Number: H4527 Organization Marketing Name: PHYSICIANS HEALTH CHOICE Parent Organization: PSO Health Services, LLC Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 16,899 [email protected] Address: 5800 Northwest Parkway Suite 125 Legal Entity Address: 8637 FREDERICKSBURG ROAD, SUITE 360 City: San Antonio City: SAN ANTONIO State: TX State: TX Zip: Zip: Last Updated: 8/18/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 139 of 190
140 Legal Entity Name: PUGET SOUND HEALTH PARTNERS, INC. Contract Number: H9302 Organization Marketing Name: Puget Sound Health Partners Parent Organization: Puget Sound Health Partners, Inc. Director of Marketing Name: Christine K Turner Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Seattle Enrollment: 4,445 [email protected] Address: 400 Mercer St Legal Entity Address: 7502 Lakewood Dr. W, Suite 410 Suite A City: Seattle City: Lakewood State: WA State: WA Zip: Zip: Last Updated: 5/19/2009 Legal Entity Name: QCC INSURANCE COMPANY Contract Number: H0097 Organization Marketing Name: Select Advantage Parent Organization: Independence Blue Cross Organization Type: PFFS Plan Type: PFFS Name: Plan Inquiries Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: 1901 Market St Legal Entity Address: 1901 Market Street City: Philadelphia City: Philadelphia State: PA State: PA Zip: Zip: Last Updated: 9/5/2007 Legal Entity Name: QCC INSURANCE COMPANY Contract Number: H3909 Organization Marketing Name: Personal Choice 65 Parent Organization: Independence Blue Cross Name: Plan Inquiries Contract Effective Date: 1/1/2002 Phone: CMS Region Responsible: Philadelphia Enrollment: 14,849 [email protected] Address: 1901 Market Street Legal Entity Address: 1901 MARKET STREET 28TH FLOOR City: Philadelphia City: PHILADELPHIA State: PA State: PA Zip: Zip: Last Updated: 9/6/2007 Legal Entity Name: QUALITY HEALTH PLANS, INC. Contract Number: H5402 Organization Marketing Name: Quality Health Plans Parent Organization: Quality Health Plans, Inc. Director of Compliance Name: Angela Hart Contract Effective Date: 1/1/2003 Phone: CMS Region Responsible: Atlanta Enrollment: 13,259 [email protected] Address: 4010 Gunn Highway Suite 220 Legal Entity Address: 2435 US HIGHWAY 19 SUITE 470 City: Tampa City: HOLIDAY State: FL State: FL Zip: Zip: Last Updated: 2/21/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 140 of 190
141 Legal Entity Name: REGENCE BLUE SHIELD OF IDAHO Contract Number: H1304 Organization Marketing Name: Regence BlueShield Of Idaho Parent Organization: The Regence Group Supr Ind Mktg Name: Shane Shown Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 5,510 Address: 1800 Ninth Ave Legal Entity Address: 201 High Street SE PO Box City: Seattle City: SALEM State: WA State: OR Zip: Zip: Last Updated: 8/10/2007 Legal Entity Name: REGENCE BLUECROSS BLUESHIELD OF OR Contract Number: H3817 Organization Marketing Name: Regence BlueCross BlueShield of Oregon Parent Organization: The Regence Group 7/1/2005 CMS Region Responsible: Seattle Enrollment: 59,672 Supr Ind Mktg Name: Shane Shown Phone: Address: 1800 Ninth Ave Contract Effective Date: Legal Entity Address: P.O. Box High Street SE City: Seattle City: SALEM State: WA State: OR Zip: Zip: Last Updated: 12/17/2008 Legal Entity Name: REGENCE BLUECROSS BLUESHIELD OF UT Contract Number: H4605 Organization Marketing Name: Regence BlueCross BlueShield of Utah Parent Organization: The Regence Group Supr Ind Mktg Name: Shane Shown Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 22,202 Address: 1800 Ninth Ave Legal Entity Address: P.O. Box High Street SE City: Seattle City: Salem State: WA State: OR Zip: Zip: Last Updated: 12/15/2008 Legal Entity Name: REGENCE BLUESHIELD Contract Number: H5009 Organization Marketing Name: Regence BlueShield Parent Organization: The Regence Group Supr Ind Mktg Name: Shane Shown Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Seattle Enrollment: 21,233 Address: 1800 Ninth Ave Legal Entity Address: P. O. Box High Street SE City: Seattle City: Salem State: WA State: OR Zip: Zip: Last Updated: 12/15/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 141 of 190
142 Legal Entity Name: RIVERSIDE RETIREMENT SERVICES, INC. Contract Number: H8655 Organization Marketing Name: Riverside PACE Parent Organization: Riverside Retirement Services, Inc. Organization Type: National PACE Plan Type: National PACE Marketing Manager Name: Donna Fitzgerald Contract Effective Date: 2/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: 4107 W Mercury Blvd Legal Entity Address: 1020 Old Denbigh Blvd. City: Hampton City: Newport News State: VA State: VA Zip: Zip: Last Updated: 4/16/2008 Legal Entity Name: ROCKY MOUNTAIN HEALTH CARE SERVICES Contract Number: H5167 Organization Marketing Name: Rocky Mountain PACE Parent Organization: Rocky Mountain Health Care Services Organization Type: National PACE PACE Site Director Plan Type: National PACE Name: Kris Abbott Contract Effective Date: 12/1/2008 Phone: CMS Region Responsible: Denver Enrollment: 20 [email protected] Address: 2335 Robinson Street Legal Entity Address: 2335 Robinson Street City: Colorado Springs City: Colorado Springs State: CO State: CO Zip: Zip: Last Updated: 2/8/2008 Legal Entity Name: ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION Contract Number: H0602 Organization Marketing Name: Rocky Mountain Health Plans Parent Organization: Rocky Mountain Health Maintenance, Inc. Organization Type: 1876 Cost Plan Type: 1876 Cost Name: RMHP Customer Service Contract Effective Date: 11/1/1977 Phone: CMS Region Responsible: Denver Enrollment: 21,904 [email protected] Address: PO Box Legal Entity Address: 2775 CROSSROADS BLVD. City: Grand Junction City: GRAND JUNCTION State: CO State: CO Zip: Zip: Last Updated: 9/10/2008 Legal Entity Name: ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC. Contract Number: H2997 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 142 of 190
143 Legal Entity Name: ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICES, INC. Contract Number: H9452 Organization Marketing Name: Anthem Blue Cross and Blue Shield Parent Organization: Wellpoint, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Chicago Enrollment: 1,285 Address: P.O. Box 9154 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Oxnard City: Thousand Oaks Zip: Zip: Last Updated: 7/13/2007 Legal Entity Name: SAMARITAN HEALTH PLANS, INC. Contract Number: H3811 Organization Marketing Name: Samaritan Advantage Health Plan Parent Organization: Samaritan Health Services 6/1/2005 Marketing Manager Name: Cristie Lynch Phone: Contract Effective Date: CMS Region Responsible: Seattle Enrollment: 4,913 [email protected] Address: 815 NW 9th Street Legal Entity Address: 815 NW 9TH STREET, SUITE 103 Suite NW Samaritan Dr. City: Corvallis City: CORVALLIS State: OR State: OR Zip: Zip: Last Updated: 7/21/2008 Legal Entity Name: SAN MATEO HEALTH COMMISSION Contract Number: H5428 Organization Marketing Name: Health Plan of San Mateo Parent Organization: Health Plan of San Mateo Name: CareAdvntg Unit Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 7,422 [email protected] Address: 701 Gateway Blvd., Suite 400 Legal Entity Address: 701 GATEWAY BLVD., SUITE 400 City: South San Francisco City: SOUTH SAN FRANCISCO Zip: Zip: Last Updated: 8/18/2006 Legal Entity Name: SANTA CLARA COUNTY HEALTH AUTHORITY Contract Number: H5554 Organization Marketing Name: Santa Clara Family Health Plan Parent Organization: SANTA CLARA COUNTY HEALTH AUTHORITY Name: Pat McClelland Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 4,054 [email protected] Address: 210 E. Hacienda Avenue Legal Entity Address: 210 E. Hacienda Avenue City: Campbell City: Campbell Zip: Zip: Last Updated: 9/11/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 143 of 190
144 Legal Entity Name: SANTE FE EMPLOYEES HOSPITAL ASSN. Contract Number: H6053 Organization Marketing Name: Santa Fe Employes Hospital Assn. - Coast Lines Parent Organization: Sante Fe Employees Hospital Assn. Organization Type: HCPP Cost Plan Type: HCPP Cost Business Manager / Controller Name: Myrna L Montana Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 551 e. San Bernardino Road, Legal Entity Address: 551 E. SAN BERNARDINO ROAD City: Covina City: COVINA Zip: Zip: Last Updated: 7/7/2008 Legal Entity Name: SCAN HEALTH PLAN Contract Number: H5425 Organization Marketing Name: SCAN Health Plan Parent Organization: SCAN Health Plan, Inc. Vice President, Marketing Name: Hans Eckardt Contract Effective Date: 5/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 36,005 [email protected] Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Aiport Way Suite 100 Suite 100 City: Long Beach City: Long Beach Zip: Zip: Last Updated: 5/25/2007 Legal Entity Name: SCAN HEALTH PLAN Contract Number: H5943 Organization Marketing Name: VillageHealth Parent Organization: SCAN Health Plan, Inc. Organization Type: Demo Vice President, Marketing Plan Type: ESRD II - HMOPOS Name: Hans Eckardt Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Airport Way Suite 100 Suite 100 City: Long Beach City: Long Beach Zip: Zip: Last Updated: 8/10/2006 Legal Entity Name: SCAN HEALTH PLAN Contract Number: H9104 Organization Marketing Name: SCAN Health Plan Parent Organization: SCAN Health Plan, Inc. Vice President, Marketing Name: Hans Eckardt Contract Effective Date: 3/1/1985 Phone: CMS Region Responsible: San Francisco Enrollment: 73,103 [email protected] Address: 3800 Kilroy Airport Way Legal Entity Address: 3800 Kilroy Airport Way Suite 100 Suite 100 City: Long Beach City: Long Beach Zip: Zip: Last Updated: 5/25/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 144 of 190
145 Legal Entity Name: SCAN HEALTH PLAN OF ARIZONA Contract Number: H9385 Organization Marketing Name: SCAN Health Plan Arizona Parent Organization: SCAN Health Plan, Inc. President Name: Thomas Lescault Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 1,414 Address: 1313 East Osborn Road Legal Entity Address: 3800 Kilroy Airport Way Suite 100 Suite 150 City: Phoenix City: Long Beach State: AZ Zip: Zip: Last Updated: 9/23/2008 Legal Entity Name: SCOTT AND WHITE HEALTH PLAN Contract Number: H4564 Organization Marketing Name: Scott and White Health Plan SeniorCare Parent Organization: Scott and White Organization Type: 1876 Cost Plan Type: 1876 Cost 4/1/1996 CMS Region Responsible: Dallas Enrollment: 23,575 Call Center Phone: Address: 2401 South 31st Street Contract Effective Date: Legal Entity Address: 2401 SOUTH 31ST STREET City: Temple City: TEMPLE State: TX State: TX Zip: Zip: Last Updated: 8/21/2006 Legal Entity Name: SDM HEALTHCARE MANAGEMENT, INC. Contract Number: H4009 Organization Marketing Name: Salud Dorada con Medicare Parent Organization: SDM Healthcare Management, Inc. Director of Medicare Programs & Compliance Name: Hector L Feliciano Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: New York Enrollment: 6,117 [email protected] Address: P.O. Box 3078 Legal Entity Address: 28 Calle Santa Cruz City: Bayamon City: Bayam n State: PR State: PR Zip: Zip: Last Updated: 4/7/2009 Legal Entity Name: SECURITY HEALTH PLAN OF WISCONSIN, INC Contract Number: H5211 Organization Marketing Name: Security Health Plan Of Wisconsin, Inc Parent Organization: Marshfield Clinic. Customer Service Manager Name: Ken Baur Contract Effective Date: 8/1/2002 Phone: CMS Region Responsible: Chicago Enrollment: 22,005 [email protected] Address: 1515 Saint Joseph Avenue Legal Entity Address: 1515 SAINT JOSEPH AVENUE PO Box 8000 PO Box 8000 City: Marshfield City: MARSHFIELD State: WI State: WI Zip: Zip: Last Updated: 5/19/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 145 of 190
146 Legal Entity Name: SELECTCARE HEALTH PLANS, INC. Contract Number: H5656 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Service Representative Name: Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 5,497 Address: 4888 Loop Central Drive Legal Entity Address: 4888 Loop Central Drive Suite 900 Suite 800 City: Houston City: Houston State: TX State: TX Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: SELECTCARE OF OKLAHOMA, INC. Contract Number: H3708 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Service Representative Name: Member Services Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 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: Zip: Last Updated: 12/9/2008 Legal Entity Name: SELECTCARE OF TEXAS, L.L.C. Contract Number: H4506 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Service Representative Name: Member Services Contract Effective Date: 3/1/2001 Phone: CMS Region Responsible: Dallas Enrollment: 44,172 Address: 4888 Loop Central Drive Legal Entity Address: 4888 Loop Central Drive Suite 900 Suite 300 City: Houston City: Houston State: TX State: TX Zip: Zip: Last Updated: 12/9/2008 Legal Entity Name: SENIOR CARE CONNECTION, INC. Contract Number: H3322 Organization Marketing Name: Senior Care Connection, Inc. Parent Organization: Senior Care Connection, Inc. Organization Type: National PACE Plan Type: National PACE VP/DIrector Name: Bernadette Hallam Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: New York Enrollment: Address: 504 State Street Legal Entity Address: 504 STATE STREET City: Schenectady City: SCHENECTADY State: NY State: NY Zip: Zip: Last Updated: 8/21/2006 June 2009 Contract Directory Sorted by Legal Entity Name Page 146 of 190
147 Legal Entity Name: SENIOR WHOLE HEALTH, LLC Contract Number: H2224 Organization Marketing Name: Senior Whole Health Parent Organization: Senior Whole Health, LLC VP, Information Technology Name: Mike Levoshko Contract Effective Date: 8/1/2004 Phone: CMS Region Responsible: Boston Enrollment: 4,865 Address: 58 Charles Street, 2nd Floor Legal Entity Address: 58 Charles Street, 2nd Floor City: Cambridge City: CAMBRIDGE State: MA State: MA Zip: Zip: Last Updated: 2/8/2007 Legal Entity Name: SENIOR WHOLE HEALTH, LLC Contract Number: H5992 Organization Marketing Name: Senior Whole Health of New York Parent Organization: Senior Whole Health, LLC VP, Information Technology Name: Mike Levoshko Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Boston Enrollment: Address: 58 Charles Street, 2nd Floor Legal Entity Address: 58 Charles Street, 2nd Floor City: Cambridge City: Cambridge State: MA State: MA Zip: Zip: Last Updated: 2/8/2007 Legal Entity Name: SENTARA LIFE CARE CORPORATION, INC Contract Number: H2941 Organization Marketing Name: Sentara Senior Community Care Parent Organization: Sentara Health Care (SHC) Organization Type: National PACE Plan Type: National PACE Name: Laura Gadsby Contract Effective Date: 11/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: 665 Newtown Road Legal Entity Address: 665 NEWTOWN ROAD Suite 121 SUITE 121 City: Virginia Beach City: VIRGINIA BEACH State: VA State: VA Zip: Zip: Last Updated: 12/18/2006 Legal Entity Name: SHA, L.L.C Contract Number: H4525 Organization Marketing Name: FirstCare Advantage Parent Organization: Covenant Health System - Hendrick Health System Customer Service Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 1,996 [email protected] Address: 1901 West Loop 289, Suite 9 Legal Entity Address: North Highway 183 City: Lubbock City: Austin State: TX State: TX Zip: Zip: Last Updated: 5/26/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 147 of 190
148 Legal Entity Name: SIDNEY HILLMAN HC Contract Number: H6141 Organization Marketing Name: Sidney Hillman HC Parent Organization: Sidney Hillman Health Center (SHHC) Organization Type: HCPP Cost Plan Type: HCPP Cost Contract Effective Date: 2/1/1983 CMS Region Responsible: Chicago Enrollment: 955 Legal Entity Address: 333 SOUTH ASHLAND AVENUE City: CHICAGO State: IL Zip: Legal Entity Name: SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. Contract Number: H2905 No contact data submitted Name: Phone: Address: City: State: Zip: Last Updated: Organization Marketing Name: Sierra Health and Life Insurance Company, Inc. Network Contract Coordinator Name: David Gardineer Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: P.O. Box Legal Entity Address: 2724 N. Tenaya Way City: Las Vegas City: Las Vegas State: NV State: NV Zip: Zip: Last Updated: 3/10/2009 Legal Entity Name: SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. Contract Number: H4449 Organization Marketing Name: Sierra Health and Life Insurance Company, Inc. Organization Type: PFFS Network Contract Coordinator Plan Type: PFFS Name: David Gardineer Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 3,336 [email protected] Address: P.O. Box Legal Entity Address: 2720 N. Tenaya Way City: Las Vegas City: Las Vagas State: NV State: NV Zip: Zip: Last Updated: 6/12/2008 Legal Entity Name: SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. Contract Number: R5674 Organization Marketing Name: Sierra Health and Life Insurance Company, Inc. Organization Type: Regional CCP Plan Type: Regional PPO Director, Government Programs/Member Services Name: David Stuczynski Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 3,525 [email protected] Address: 2716 N. Tenaya Way Legal Entity Address: 2720 N. Tenaya Way City: Las Vegas City: Las Vegas State: NV State: NV Zip: Zip: Last Updated: 6/12/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 148 of 190
149 Legal Entity Name: SIOUXLAND PACE, INC. Contract Number: H8424 Organization Marketing Name: SIOUXLAND PACE, INC. Parent Organization: Siouxland PACE, Inc. Organization Type: National PACE Plan Type: National PACE Director Name: Linda D Todd Contract Effective Date: 8/1/2008 Phone: CMS Region Responsible: Kansas City Enrollment: 33 toddl@hospic .com Address: 4300 Hamilton Blvd Legal Entity Address: 4300 Hamilton Blvd City: Sioux City City: Sioux City State: IA State: IA Zip: Zip: Last Updated: 1/22/2008 Legal Entity Name: SOUTH COUNTRY HEALTH ALLIANCE Contract Number: H2419 Organization Marketing Name: South Country Health Alliance Parent Organization: South Country Health Alliance Manager Marketing and Communication Name: Ellen Lewis Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Chicago Enrollment: 1,867 [email protected] Address: 110 West Fremont Street Legal Entity Address: 110 West Fremont Street City: Owatonna City: OWATONNA State: MN State: MN Zip: Zip: Last Updated: 3/30/2009 Legal Entity Name: SOUTH COUNTRY HEALTH ALLIANCE Contract Number: H5703 Organization Marketing Name: South Country Health Alliance Parent Organization: South Country Health Alliance Marketing and Communications Manager Name: Ellen Lewis Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Chicago Enrollment: [email protected] Address: 110 West Fremont Street Legal Entity Address: 110 West Fremont Street City: Owatonna City: Owatonna State: MN State: MN Zip: Zip: Last Updated: 3/30/2009 Legal Entity Name: SOUTHWEST CATHOLIC HEALTH NETWORK CORPORATION Contract Number: H5580 Organization Marketing Name: Mercy Care Advantage Parent Organization: Southwest Catholic Health Network Director, Customer and Enrollment Services Name: Cathy Waldbillig Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 14,766 [email protected] 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: Zip: Last Updated: 10/13/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 149 of 190
150 Legal Entity Name: ST. AGNES CONTINUING CARE CENTER Contract Number: H3919 Organization Marketing Name: Mercy LIFE Parent Organization: St. Agnes Continuing Care Center Organization Type: National PACE Director, Outreach and Enrollment Plan Type: National PACE Name: Erin Oldt Contract Effective Date: 10/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: 1900 S. Broad Street Legal Entity Address: 1900 South Broad Street City: Philadelphia City: PHILADELPHIA State: PA State: PA Zip: Zip: Last Updated: 4/3/2008 Legal Entity Name: STERLING LIFE INSURANCE COMPANY Contract Number: H5006 Organization Marketing Name: Sterling Life Insurance Company Parent Organization: Munich American Holding Corporation Organization Type: PFFS Customer Service Manager Plan Type: PFFS Name: Wendi Western Contract Effective Date: 7/1/2000 Phone: CMS Region Responsible: Seattle Enrollment: 93,668 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: Zip: Last Updated: 7/25/2008 Legal Entity Name: STERLING LIFE INSURANCE COMPANY Contract Number: H5606 Organization Marketing Name: Fresenius Medical Health Plan, Inc. - Pennsylvania Parent Organization: Munich American Holding Corporation Organization Type: Demo Customer Service Manager Plan Type: ESRD I - PFFS Name: Wendi Western Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Seattle Enrollment: [email protected] Address: 2219 Rimland Drive Legal Entity Address: 2219 Rimland Drive PO Box 5348 PO Box 5348 City: Bellingham City: Bellingham State: WA State: WA Zip: Zip: Last Updated: 7/25/2008 Legal Entity Name: STERLING LIFE INSURANCE COMPANY Contract Number: H5962 Organization Marketing Name: Fresenius Medical Care Health Plan, Inc. - Texas Parent Organization: Munich American Holding Corporation Organization Type: Demo Customer Service Manager Plan Type: ESRD I - PFFS Name: Wendi Western Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Seattle Enrollment: [email protected] Address: 2219 Rimland Drive Legal Entity Address: 2219 Rimland Drive PO Box 5348 PO Box 5348 City: Bellingham City: Bellingham State: WA State: WA Zip: Zip: Last Updated: 7/25/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 150 of 190
151 Legal Entity Name: STERLING LIFE INSURANCE COMPANY (MT) Contract Number: H5839 Organization Marketing Name: Sterling Life Insurance Company Parent Organization: Munich American Holding Corporation Organization Type: PFFS Customer Service Manager Plan Type: PFFS Name: Wendi Western Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Seattle Enrollment: Address: 2219 Rimland Drive Legal Entity Address: 2219 Rimland Dr PO Box 5348 City: Bellingham City: Bellingham State: WA State: WA Zip: Zip: Last Updated: 7/25/2008 Legal Entity Name: SUMMA INSURANCE COMPANY Contract Number: H0496 Organization Marketing Name: SummaCare Parent Organization: Summa Health System Organization Type: PFFS Director of Marketing Plan Type: PFFS Name: Tracie Kinaitis Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Chicago Enrollment: 46 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: Zip: Last Updated: 2/9/2009 Legal Entity Name: SUMMACARE INC. Contract Number: H3660 Organization Marketing Name: SummaCare Parent Organization: Summa Health System Director of Marketing Name: Tracie kinaitis Contract Effective Date: 6/1/1996 Phone: CMS Region Responsible: Chicago Enrollment: 18,742 Address: 10 North Main Street Legal Entity Address: P. O. Box North Main Steet City: Akron City: AKRON State: OH State: OH Zip: Zip: Last Updated: 2/9/2009 Legal Entity Name: SUMMIT HEALTH PLAN, INC. Contract Number: H5850 Organization Marketing Name: Summit Health Plan, Inc. Parent Organization: Coventry Health Care Inc. Name: Summit Customer Service Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 20,101 Address: 1340 Concord Terrace Legal Entity Address: 1340 Concord Terrace City: Sunrise City: Sunrise State: FL State: FL Zip: Zip: Last Updated: 8/18/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 151 of 190
152 Legal Entity Name: SUPERIOR HEALTH PLAN, INC. Contract Number: H5294 Organization Marketing Name: Advantage by SuperiorHealthPlan Parent Organization: Centene Corporation COO Name: Holly Munin Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: Address: 2100 South IH - 35, Legal Entity Address: The Regency Building, Suite 202 Suite South IH-35 City: Austin City: Austin State: TX State: TX Zip: Zip: Last Updated: 8/15/2007 Legal Entity Name: SUTTER HEALTH SACRAMENTO SIERRA REGION Contract Number: H5406 Organization Marketing Name: Sutter SeniorCare Parent Organization: Sutter Health Sacramento Sierra Region Organization Type: National PACE Plan Type: National PACE 11/1/2003 Not-for-Profit/Non-Profit Director Name: William Clearwater Phone: Contract Effective Date: Tax Status: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 7000 Franklin Blvd., Suite 1020 Legal Entity Address: 7000 Franklin Blvd., Suite 1020 City: Sacramento City: Sacramento Zip: Zip: Last Updated: 10/1/2008 Legal Entity Name: TEXAS HEALTH SPRING LLC Contract Number: H4521 Organization Marketing Name: Texas HealthSpring Parent Organization: HealthSpring, Inc. Vice President of Customer Service Name: Wendy Wetzel Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 2900 North Loop West Suite 1300 Legal Entity Address: 2900 N LOOP WEST, SUITE 1300 City: Houston City: HOUSTON State: TX State: TX Zip: Zip: Last Updated: 2/5/2009 Legal Entity Name: TEXAS HEALTHSPRING LLC Contract Number: H4513 Organization Marketing Name: Texas HealthSpring Parent Organization: HealthSpring, Inc. Vice President of Customer Service Name: Wendy Wetzel Contract Effective Date: 3/1/2001 Phone: CMS Region Responsible: Denver Enrollment: 47,836 [email protected] Address: 2900 North Loop West Suite 1300 Legal Entity Address: 2900 N LOOP WEST, SUITE 1300 City: Houston City: HOUSTON State: TX State: TX Zip: Zip: Last Updated: 12/17/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 152 of 190
153 Legal Entity Name: THE METHODIST OAKS Contract Number: H0105 Organization Marketing Name: The Methodist Oaks d.b.a. The Oaks PACE Parent Organization: The Methodist Oaks Organization Type: National PACE Plan Type: National PACE Data/Billing Specialist Name: Debbie Robinson Contract Effective Date: 3/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 31 Address: P.O.Drawer 327 Legal Entity Address: 153 Founders Court City: Orangeburg City: Orangeburg State: SC State: SC Zip: Zip: Last Updated: 9/24/2008 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H1356 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H2914 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: 32 Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H3437 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 153 of 190
154 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H5378 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H5421 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Organization Type: PFFS Member Services Representative Plan Type: PFFS Name: Member Services Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Dallas Enrollment: 125,128 Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/30/2009 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H8172 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 Legal Entity Name: THE PYRAMID LIFE INSURANCE COMPANY Contract Number: H9930 Organization Marketing Name: Universal American Parent Organization: Universal American Corp. Member Services Representative Name: Member Services Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Dallas Enrollment: Address: 4888 Loop Central Drive Legal Entity Address: 1001 Heathrow Park Lane Suite 900 Suite 5001 City: Houston City: Lake Mary State: TX State: FL Zip: Zip: Last Updated: 1/24/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 154 of 190
155 Legal Entity Name: THP INSURANCE COMPANY Contract Number: H6621 Organization Marketing Name: Health Plan SecureFreedom Parent Organization: Health Plan of the Upper Ohio Valley Organization Type: PFFS Plan Type: PFFS Director Member Services Name: Sherry Stanley Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: 42 Address: The Health Plan Legal Entity Address: National Road East City: St. Clairsville State: OH National Road East City: St. Clairsville State: OH Zip: Zip: Last Updated: 2/27/2007 Legal Entity Name: THP INSURANCE COMPANY Contract Number: H8604 Organization Marketing Name: Health Plan SecureChoice Parent Organization: Health Plan of the Upper Ohio Valley 1/1/2008 Director Member Services Name: Sherry Stanley Phone: Contract Effective Date: CMS Region Responsible: Philadelphia Enrollment: Address: The Health Plan Legal Entity Address: National Road East National Road East City: St. Clairsville State: OH Zip: Last Updated: City: St. Clairsville State: OH Zip: /28/2007 Legal Entity Name: TOTAL COMMUNITY CARE, L.L.C. Contract Number: H5213 Organization Marketing Name: Total Community Care Parent Organization: Total Community Care,LLC Organization Type: National PACE AVP Medicare and Medicaid Compliance Plan Type: National PACE Name: Matthew Zimmerman Contract Effective Date: 6/1/2004 Phone: CMS Region Responsible: Dallas Enrollment: Address: 200 E. 9th Ave. Legal Entity Address: 904 A LAS LOMAS N.E. City: Denver City: Albuquerque State: CO State: NM Zip: Zip: Last Updated: 9/25/2008 Legal Entity Name: TOTAL LIFE HEALTHCARE Contract Number: H4305 Organization Marketing Name: Total Life Healthcare Parent Organization: St. Bernard's Healthcare Organization Type: National PACE Plan Type: National PACE Finance Manager Name: Terry Combs Contract Effective Date: 6/1/2008 Phone: CMS Region Responsible: Dallas Enrollment: 20 [email protected] Address: 225 East Jackson #92 Legal Entity Address: 225 East Jackson #92 City: Jonesboro City: Jonesboro State: AR State: AR Zip: Zip: Last Updated: 4/30/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 155 of 190
156 Legal Entity Name: TOTAL LONGTERM CARE, INC. Contract Number: H0613 Organization Marketing Name: Total Longterm Care, Inc. Parent Organization: Total Longterm Care, Inc. Organization Type: National PACE AVP Medicare and Medicaid Compliance Plan Type: National PACE Name: Matthew Zimmerman Contract Effective Date: 4/1/2003 Phone: CMS Region Responsible: Denver Enrollment: 1,312 Address: 200 E. 9th Ave. Legal Entity Address: 200 E. 9TH AVENUE City: Denver City: DENVER State: CO State: CO Zip: Zip: Last Updated: 12/4/2008 Legal Entity Name: TOTAL SENIOR CARE, INC. Contract Number: H8800 Organization Marketing Name: Total Senior Care, Inc. Parent Organization: TOTAL SENIOR CARE, INC. Organization Type: National PACE Program Officer Plan Type: National PACE Name: Ann Feightner Contract Effective Date: 10/1/2008 Phone: CMS Region Responsible: New York Enrollment: * [email protected] Address: 519 North Union Street Legal Entity Address: 519 North Union Street City: Olean City: Olean State: NY State: NY Zip: Zip: Last Updated: 12/16/2008 Legal Entity Name: TOUCHSTONE HEALTH HMO, INC. Contract Number: H3327 Organization Marketing Name: Touchstone Health Parent Organization: Touchstone Health Partnership, Inc Director, Member Services Name: Adrian Ochoa Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: New York Enrollment: 13,911 [email protected] Address: 14 Wall Street Legal Entity Address: 14 Wall Street, 9th Floor City: New York City: New York State: NY State: NY Zip: Zip: Last Updated: 5/20/2009 Legal Entity Name: TOUCHSTONE HEALTH HMO, INC. Contract Number: H3366 Organization Marketing Name: Touchstone Health Parent Organization: Touchstone Health Partnership, Inc Director, Member Services Name: Adrian Ochoa Contract Effective Date: 3/1/1996 Phone: CMS Region Responsible: New York Enrollment: [email protected] Address: 14 Wall Street Legal Entity Address: 14 Wall Street City: New York City: New York State: NY State: NY Zip: Zip: Last Updated: 5/20/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 156 of 190
157 Legal Entity Name: TRIHEALTH SENIORLINK Contract Number: H3614 Organization Marketing Name: Trihealth Seniorlink Parent Organization: TriHealth SeniorLink Organization Type: National PACE Plan Type: National PACE Marketing/Intake coordinator Name: Jayne Miller Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: Chicago Enrollment: Address: 619 Oak Street Legal Entity Address: 4750 WESLEY AVENUE SUITE J City: Cincinnati City: CINCINNATI State: OH State: OH Zip: Zip: Last Updated: 9/12/2006 Legal Entity Name: TRILLIUM COMMUNITY HEALTH PLAN Contract Number: H2174 Organization Marketing Name: Trillium Advantage Parent Organization: Trillium Community Health Plan 1/1/2007 Medicare Director Name: Shannon Conley Phone: Contract Effective Date: CMS Region Responsible: Seattle Enrollment: 2,904 [email protected] Address: 1800 Millrace Drive Legal Entity Address: 1800 Millrace Drive City: Eugene City: Eugene State: OR State: OR Zip: Zip: Last Updated: 1/18/2008 Legal Entity Name: TRIPLE-S SALUD, INC. Contract Number: H4005 Organization Marketing Name: Triple-S Salud, Inc. Parent Organization: Triple-S Management Corporation Customer Service Manager Name: Armando Gonzalez Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: New York Enrollment: 35,118 [email protected] Address: 1441 Franklin D. Roosevelt Ave. Legal Entity Address: PO BOX City: San Juan City: SAN JUAN State: PR State: PR Zip: Zip: Last Updated: 8/25/2008 Legal Entity Name: TRIPLE-S SALUD, INC. Contract Number: H4012 Organization Marketing Name: Triple-S Salud, Inc. Parent Organization: Triple-S Management Corporation Customer Service Manager Name: Armando Gonzalez Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: New York Enrollment: 24,275 [email protected] Address: 1441 Franklin D. Roosevelt Ave. Legal Entity Address: PO BOX AVE ROOSEVELT City: San Juan City: SAN JUAN State: PR State: PR Zip: Zip: Last Updated: 8/25/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 157 of 190
158 Legal Entity Name: TRIPLE-S SALUD, INC. Contract Number: H5732 Organization Marketing Name: Triple-S Salud, INC. Parent Organization: Triple-S Management Corporation Customer Service Manager Name: Armando Gonzalez Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: New York Enrollment: 1,455 Address: 1441 Franklin D. Roosevelt Ave. Legal Entity Address: P. O. Box City: San Juan City: San Juan State: PR State: PR Zip: Zip: Last Updated: 8/25/2008 Legal Entity Name: TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA Contract Number: H3908 Organization Marketing Name: Trustees Of The University Of Pennsylvania Parent Organization: Trustees of the University of Pennsylvania Organization Type: National PACE Plan Type: National PACE 1/1/2002 CMS Region Responsible: Philadelphia Enrollment: 344 Executive Director Name: Wayne Pendelton Phone: Address: 4508 Chestnut Street Contract Effective Date: Legal Entity Address: 4508 Chestnut Street City: Philadelphia City: PHILADELPHIA State: PA State: PA Zip: Zip: Last Updated: 5/21/2007 Legal Entity Name: TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, Contract Number: H3057 Organization Marketing Name: Tufts Health Plan Parent Organization: TAHMO, Inc. Organization Type: PFFS Plan Type: PFFS Tufts MP Marketing Communications Manager Name: Dana Cutter Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Boston Enrollment: 1,510 Address: 705 Mt Auburn St Legal Entity Address: 705 Mt Auburn Street City: Watertown City: Watertown State: MA State: MA Zip: Zip: Last Updated: 5/28/2009 Legal Entity Name: TUFTS ASSOCIATED HMO, INC. Contract Number: H2229 Organization Marketing Name: Tufts Health Plan Parent Organization: TAHMO, Inc. Tufts MP Marketing Communications Manager Name: Dana Cutter Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: Boston Enrollment: 4,846 Address: 705 Mt Auburn St Legal Entity Address: 705 Mt Auburn Street City: Watertown City: Watertown State: MA State: MA Zip: Zip: Last Updated: 5/28/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 158 of 190
159 Legal Entity Name: TUFTS ASSOCIATED HMO, INC. Contract Number: H2256 Organization Marketing Name: Tufts Health Plan Parent Organization: TAHMO, Inc. Contract Effective Date: 7/1/1994 CMS Region Responsible: Boston Enrollment: 74,653 Legal Entity Address: 705 Mt Auburn Street City: Watertown State: MA Zip: Legal Entity Name: UAHC HEALTH PLAN OF TENNESSEE, INC. Contract Number: H6934 Organization Marketing Name: UAHC Gold Parent Organization: UAHC HEALTH PLAN OF TENNESSEE Contract Effective Date: 1/1/2007 CMS Region Responsible: Atlanta Enrollment: 624 Legal Entity Address: 1769 Paragon Drive, Suite 100 City: Memphis State: TN Zip: Legal Entity Name: UCARE MINNESOTA Contract Number: H2407 Organization Marketing Name: UCare Parent Organization: UCare Minnesota Contract Effective Date: 11/1/2001 CMS Region Responsible: Chicago Enrollment: 677 Legal Entity Address: 500 Stinson Blvd NE City: MINNEAPOLIS State: MN Zip: Legal Entity Name: UCARE MINNESOTA Contract Number: H2456 Organization Marketing Name: UCare Parent Organization: UCare Minnesota Contract Effective Date: 1/1/1997 CMS Region Responsible: Chicago Enrollment: 8,239 Legal Entity Address: 500 Stinson Blvd NE City: MINNEAPOLIS State: MN Zip: Tufts MP Marketing Communications Manager Name: Dana Cutter Phone: Address: 705 Mt Auburn St City: Watertown State: MA Zip: Last Updated: 5/28/2009 Name: Nicole Gibson Phone: Address: 6555 Quince Road Suite 300A City: Memphis State: TN Zip: Last Updated: 5/27/2009 State Programs Member Services Supervisor Name: Jaimie Parker Phone: Address: PO Box 52 City: Minneapolis State: MN Zip: Last Updated: 5/25/2007 State Programs Member Services Supervisor Name: Jaimie Parker Phone: Address: PO Box 52 City: Minneapolis State: MN Zip: Last Updated: 5/25/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 159 of 190
160 Legal Entity Name: UCARE MINNESOTA Contract Number: H2459 Organization Marketing Name: UCare Parent Organization: UCare Minnesota Contract Effective Date: 5/1/1998 CMS Region Responsible: Chicago Enrollment: 59,409 Legal Entity Address: 500 Stinson Boulevard NE City: MINNEAPOLIS State: MN Zip: Legal Entity Name: UCARE WISCONSIN, INC. Contract Number: H4270 Organization Marketing Name: UCare Parent Organization: UCare Minnesota Contract Effective Date: 1/1/2008 CMS Region Responsible: Chicago Enrollment: 2,814 Legal Entity Address: 500 Stinson Boulevard NE City: Minneapolis State: MN Zip: Legal Entity Name: UNICARE LIFE AND HEALTH INS. COMPANY Contract Number: H0540 Organization Marketing Name: Unicare Life & Health Ins. Company Parent Organization: Wellpoint, Inc. Organization Type: PFFS Plan Type: PFFS Contract Effective Date: 4/1/2003 CMS Region Responsible: Chicago Enrollment: 104,786 Legal Entity Address: 1 WellPoint Way CAT201-C004 City: Thousand Oaks Zip: Legal Entity Name: UNION HEALTH SERVICES, INC. Contract Number: H6142 Organization Marketing Name: Union Health Service, Inc. Parent Organization: Union Health Services, Inc. Organization Type: HCPP Cost Plan Type: HCPP Cost Contract Effective Date: 2/1/1983 CMS Region Responsible: Chicago Enrollment: 1,485 Legal Entity Address: 1634 WEST POLK STREET City: CHICAGO State: IL Zip: Medicare Customer Services Supervisor Name: Vatisha Hammick Phone: [email protected] Address: PO Box 52 City: Minneapolis State: MN Zip: Last Updated: 5/29/2008 Medicare Customer Services Supervisor Name: Vatisha Hammick Phone: [email protected] Address: PO Box 52 City: Minneapolis State: MN Zip: Last Updated: 5/29/2008 Phone: [email protected] Address: P.O. Box 9154 City: Oxnard Zip: Last Updated: 7/13/2007 No contact data submitted Name: Phone: Address: City: State: Zip: Last Updated: June 2009 Contract Directory Sorted by Legal Entity Name Page 160 of 190
161 Legal Entity Name: UNION MEDICAL CENTER Contract Number: H6143 Organization Marketing Name: Union Medical Center Parent Organization: Union Medical Center Organization Type: HCPP Cost Plan Type: HCPP Cost Contract Effective Date: 2/1/1983 CMS Region Responsible: Chicago Enrollment: 773 Legal Entity Address: 1657 WEST ADAMS STREET City: CHICAGO State: IL Zip: Legal Entity Name: UNION PACIFIC RR EMPLOYES HEALTH SYS Contract Number: H4652 Organization Marketing Name: Union Pacific Railroad Employes Health Systems Parent Organization: Union Pacific Railroad Employees Health Systems Organization Type: HCPP Cost Plan Type: HCPP Cost 12/1/1993 No contact data submitted Name: Phone: Address: City: State: Zip: Last Updated: Manager of Customer Services Name: Deeann Benson Phone: Contract Effective Date: CMS Region Responsible: Denver Enrollment: 11,623 [email protected] Address: 1040 N 2200 W Suite 200 Legal Entity Address: 1040 N 2200 W Suite 200 City: Salt Lake City City: Salt Lake City State: UT State: UT Zip: Zip: Last Updated: 8/25/2008 Legal Entity Name: UNISON HEALTH PLAN OF OHIO, INC. Contract Number: H1364 Organization Marketing Name: Unison Advantage Name: Member Services Dept Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: Unison Plaza Legal Entity Address: 2800 Corporate Exchange Drive 1001 Brinton Road Suite 200 City: Pittsburgh City: Columbus State: PA State: OH Zip: Zip: Last Updated: 11/13/2008 Legal Entity Name: UNISON HEALTH PLAN OF PENNSYLVANIA, INC. Contract Number: H3920 Organization Marketing Name: Unison Advantage Name: Member Services Dept Contract Effective Date: 4/1/2005 Phone: CMS Region Responsible: Philadelphia Enrollment: 17,103 [email protected] Address: Unison Plaza Legal Entity Address: 1001 Brinton Road 1001 Brinton Road City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 12/3/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 161 of 190
162 Legal Entity Name: UNISON HEALTH PLAN OF TENNESSEE, INC. Contract Number: H0245 Organization Marketing Name: Unison Advantage Name: Member Services Dept Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: 41 Address: Unison Plaza Legal Entity Address: 890 Willow Tree Circle 1001 Brinton Road Suite 10 City: Pittsburgh City: Cordova State: PA State: TN Zip: Zip: Last Updated: 4/23/2007 Legal Entity Name: UNISON HEALTH PLAN OF TENNESSEE, INC. Contract Number: H5189 Organization Marketing Name: Unison Advantage Name: Member Services Dept Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: Address: Unison Plaza Legal Entity Address: 890 Willow Tree Circle 1001 Brinton Road Suite 10 City: Pittsburgh City: Cordova State: PA State: TN Zip: Zip: Last Updated: 4/23/2007 Legal Entity Name: UNISON HEALTH PLAN OF TENNESSEE, INC. Contract Number: H5998 Organization Marketing Name: Unison Advantage Name: Medicare Member Services Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: 4,388 Address: Unison Plaza Legal Entity Address: 890 Willow Tree Circle, Suite 10 City: Cordova 1001 Brinton Road City: Pittsburgh State: PA State: TN Zip: Zip: Last Updated: 4/17/2007 Legal Entity Name: UNITED MINE WORKERS OF AMERICA HEALTH & RETIREMENT Contract Number: Organization Marketing Name: United Mine Workers of America Health & Retirement Parent Organization: UNITED MINE WORKERS OF AMERICA Organization Type: HCPP Cost Plan Type: HCPP Cost Name: Health Call Center Contract Effective Date: 2/1/1974 Phone: CMS Region Responsible: Philadelphia Enrollment: 36,131 [email protected] Address: P.O. Box 2320 Legal Entity Address: 2121 K STREET, N.W. SUITE 350 City: Beckley City: WASHINGTON State: WV State: DC Zip: Zip: Last Updated: 4/24/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 162 of 190
163 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H0319 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 7,417 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H0408 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 33 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H0410 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN0084-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H0620 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,880 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 163 of 190
164 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H0624 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 4,868 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H0710 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 7/1/2004 Phone: CMS Region Responsible: San Francisco Enrollment: 6,567 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H1108 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 12,132 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN800-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H1286 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 4,459 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 164 of 190
165 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H1303 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 3,692 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA City: Cyress Zip: City: MINNETONKA State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H1509 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 13,313 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H1717 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 4/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,145 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD E. CA MN008-T500 City: Cyress City: MINNETONKA State: KS Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H1944 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA Mail Route MN-008 W140 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 165 of 190
166 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2001 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,376 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA City: Cyress Zip: City: Minnetonka State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2003 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 5757 Plaza Dr Legal Entity Address: 450 COLUMBUS BOULEVARD CA City: Cyress City: HARTFORD State: CT Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2111 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 6,805 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2182 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: San Francisco Enrollment: 1,692 [email protected] Address: 5757 Plaza Dr Legal Entity Address: c/o UnitedHealth Group/Ovations, 9900 Bren Rd East, CA Mail Rout MN008-W840 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 166 of 190
167 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2226 Organization Marketing Name: Evercare«Senior Care Options Name: Richard Irwin Contract Effective Date: 3/1/2004 Phone: CMS Region Responsible: San Francisco Enrollment: 3,416 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA City: Cyress Zip: City: MINNETONKA State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2228 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 9,972 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2406 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 6/1/2001 Phone: CMS Region Responsible: San Francisco Enrollment: 1,956 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H2803 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 4/1/2003 Phone: CMS Region Responsible: San Francisco Enrollment: 5,662 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 167 of 190
168 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H3209 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 8/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA City: Cyress Zip: City: MINNETONKA State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H3435 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H3812 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 5,154 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-T500 City: Cyress City: MINNETONKA State: OR Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H3887 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 4,919 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 168 of 190
169 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H3912 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 9/1/2002 Phone: CMS Region Responsible: San Francisco Enrollment: 3,332 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-W130 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H3921 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MN008-T440 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H4106 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 2,733 Address: 5757 Plaza Dr Legal Entity Address: 475 KILVERT STREET CA SUITE 310 City: Cyress City: WARWICK State: RI Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H4522 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 10,050 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 169 of 190
170 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H4779 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Rd E CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H4971 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA Mail Route MN-008 W140 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5008 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 5,250 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5417 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 29,022 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 4350 WEST CYPRESS STREET CA SUITE 1000 City: Cyress City: TAMPA State: FL Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 170 of 190
171 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5424 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 6/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 8,687 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA City: Cyress Zip: City: Minnetonka State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5435 Organization Marketing Name: SecureHorizons MedicareDirect Organization Type: PFFS Plan Type: PFFS Name: Richard Irwin Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 246,123 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-T615 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5440 Organization Marketing Name: Evercare«Health Plans Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,012 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 4350 WEST CYPRESS STREET CA SUITE 1000 City: Cyress City: TAMPA State: FL Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5507 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 4,222 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 171 of 190
172 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5516 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 1,680 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress Zip: City: Minnetonka State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5532 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5652 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,004 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5678 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-W130 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 172 of 190
173 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5697 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 1,056 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-W130 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5749 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA Mail Route MN-008-W140 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5754 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-W130 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H5918 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA MN008-W130 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 173 of 190
174 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H6228 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA Mail Route MN-008-W140 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H6793 Organization Marketing Name: Erickson Advantage Organization Type: Demo Plan Type: Continuing Care Retirement Community Name: Richard Irwin Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: 83 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA Mail Route MN-008 W140 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H7187 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 1,898 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Rd East CA MN008-T440 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H8748 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: c/o UnitedHealth Group/Ovations, 9900 Bren Rd East CA MAIL ROUTE MN0008-W240 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 174 of 190
175 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: H9149 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: San Francisco Enrollment: * [email protected] Address: 5757 Plaza Dr Legal Entity Address: c/o UnitedHealth Group/Ovations, 9900 Bren Rd East, CA MAIL ROUTE MN008-\W240 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: R3175 Organization Marketing Name: SecureHorizons by UnitedHealthcare Organization Type: Regional CCP Plan Type: Regional PPO Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 2,636 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: R5287 Organization Marketing Name: SecureHorizons by UnitedHealthcare Organization Type: Regional CCP Plan Type: Regional PPO Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 69,547 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY Contract Number: R7444 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Organization Type: Regional CCP Plan Type: Regional PPO Name: Richard Irwin Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: San Francisco Enrollment: 3,709 [email protected] Address: 5757 Plaza Dr Legal Entity Address: c/o UnitedHealth Group/Ovations, 9900 Bren Rd East CA MAIL ROUTE MN008-W240 City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 175 of 190
176 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK Contract Number: H4720 Organization Marketing Name: SecureHorizons MedicareDirect Organization Type: PFFS Plan Type: PFFS Name: Richard Irwin Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: C/O Ovations, SRS, 9900 Bren Road East, MN008-T44 CA City: Cyress Zip: City: Minnetonka State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK Contract Number: R5342 Organization Marketing Name: SecureHorizons by UnitedHealthcare Organization Type: Regional CCP Plan Type: Regional PPO Name: Richard Irwin Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: San Francisco Enrollment: 16,296 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road East CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF ALABAMA, INC. Contract Number: H0151 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 2/1/1995 Phone: CMS Region Responsible: San Francisco Enrollment: 32,915 Address: 5757 Plaza Dr Legal Entity Address: NW 12TH ST CA City: Cyress City: SUNRISE State: FL Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF ARIZONA, INC. Contract Number: H0316 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 9/1/2004 Phone: CMS Region Responsible: San Francisco Enrollment: 6,980 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MAIL ROUTE MN008-W140 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 176 of 190
177 Legal Entity Name: UNITEDHEALTHCARE OF ARKANSAS, INC. Contract Number: H0401 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA City: Cyress Zip: City: MINNETONKA State: MN Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF FLORIDA, INC. Contract Number: H1080 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/1996 Phone: CMS Region Responsible: San Francisco Enrollment: 21,207 Address: 5757 Plaza Dr Legal Entity Address: 4350 WEST CYPRESS ST. CA SUITE 908 City: Cyress City: TAMPA State: FL Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF FLORIDA, INC. Contract Number: H9011 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 10/1/1982 Phone: CMS Region Responsible: San Francisco Enrollment: 5,272 Address: 5757 Plaza Dr Legal Entity Address: N.W. 12TH ST. CA City: Cyress City: SUNRISE State: FL Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF GEORGIA, INC. Contract Number: H1111 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,755 Address: 5757 Plaza Dr Legal Entity Address: 9900 Bren Road E CA City: Cyress City: Minnetonka State: MN Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 177 of 190
178 Legal Entity Name: UNITEDHEALTHCARE OF NEW ENGLAND, INC. Contract Number: H4102 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 10/1/1987 Phone: CMS Region Responsible: San Francisco Enrollment: 17,984 Address: 5757 Plaza Dr Legal Entity Address: 3803 N ELM ST CA City: Cyress Zip: City: GREENSBORO State: NC Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF NEW YORK, INC. Contract Number: H3379 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 3/1/1997 Phone: CMS Region Responsible: San Francisco Enrollment: 9,117 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 3803 N ELM ST CA City: Cyress City: GREENSBORO State: NC Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF NEW YORK, INC. Contract Number: H3387 Organization Marketing Name: AmeriChoice Personal Care Plus Name: Member Services Contract Effective Date: 1/1/1999 Phone: CMS Region Responsible: San Francisco Enrollment: [email protected] Address: 7 HANOVER SQUARE Legal Entity Address: 7 HANOVER SQUARE 5TH FLOOR City: New York City: NEW YORK State: NY State: NY Zip: Zip: Last Updated: 5/8/2008 Legal Entity Name: UNITEDHEALTHCARE OF NORTH CAROLINA, INC. Contract Number: H3456 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 6/1/1997 Phone: CMS Region Responsible: San Francisco Enrollment: 63,198 [email protected] Address: 5757 Plaza Dr Legal Entity Address: 3803 N Elm Street CA City: Cyress City: GREENSBORO State: NC Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 178 of 190
179 Legal Entity Name: UNITEDHEALTHCARE OF OHIO, INC. Contract Number: H3659 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 5/1/1996 Phone: CMS Region Responsible: San Francisco Enrollment: 62,747 Address: 5757 Plaza Dr Legal Entity Address: 9200 WORTHINGTON ROAD CA City: Cyress Zip: City: WESTERVILLE State: OH Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF TENNESSEE, INC. Contract Number: H4406 Organization Marketing Name: AARP MedicareComplete from SecureHorizons Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 1,663 Address: 5757 Plaza Dr Legal Entity Address: 9900 BREN ROAD EAST CA MAIL ROUTE MN008-W140 City: Cyress City: MINNETONKA State: MN Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF THE MIDLANDS, INC. Contract Number: H2802 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 10/1/1985 Phone: CMS Region Responsible: San Francisco Enrollment: 4,635 Address: 5757 Plaza Dr Legal Entity Address: RIVERPORT DRIVE CA City: Cyress City: MARYLAND HEIGHTS State: MO Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF THE MIDWEST, INC. Contract Number: H2654 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 10/1/1992 Phone: CMS Region Responsible: San Francisco Enrollment: 43,819 Address: 5757 Plaza Dr Legal Entity Address: RIVERPORT DRIVE CA City: Cyress City: MARYLAND HEIGHTS State: MO Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 179 of 190
180 Legal Entity Name: UNITEDHEALTHCARE OF THE RIVER VALLEY, INC. Contract Number: H4456 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 7/1/1997 Phone: CMS Region Responsible: San Francisco Enrollment: 37,871 Address: 5757 Plaza Dr Legal Entity Address: 1300 River Drive, Suite 200 CA City: Cyress Zip: City: Moline State: IL Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF UTAH, INC. Contract Number: H4604 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 1/1/2005 Phone: CMS Region Responsible: San Francisco Enrollment: 13,337 Address: 5757 Plaza Dr Legal Entity Address: 2795 EAST COTTONWOOD PARKWAY #200 CA City: Cyress City: SALT LAKE CITY State: UT Zip: Zip: Last Updated: 4/14/2009 Legal Entity Name: UNITEDHEALTHCARE OF WISCONSIN Contract Number: H4837 Organization Marketing Name: UnitedHealthcare Personal Care Plus Name: Veronica Britt Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: 14 Address: W. Research Dr Legal Entity Address: W. Research Drive P.O. Box City: Milwaukee City: Wauwatosa State: WI State: WI Zip: Zip: Last Updated: 5/30/2008 Legal Entity Name: UNITEDHEALTHCARE OF WISCONSIN, INC Contract Number: H5253 Organization Marketing Name: SecureHorizons by UnitedHealthcare Name: Richard Irwin Contract Effective Date: 8/1/1995 Phone: CMS Region Responsible: San Francisco Enrollment: 30,321 Address: 5757 Plaza Dr Legal Entity Address: W. RESEARCH DRIVE CA P.O. BOX City: Cyress City: MILWAUKEE State: WI Zip: Zip: Last Updated: 4/14/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 180 of 190
181 Legal Entity Name: UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. Contract Number: H0251 Organization Marketing Name: AmeriChoice Secure Plus Complete Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: San Francisco Enrollment: 8,481 Address: 3800 River Drive, Suite 200 Legal Entity Address: 1300 River Drive, Suite 200 City: Moline City: Moline State: IL State: IL Zip: Zip: Last Updated: 5/22/2007 Legal Entity Name: UNIVERSAL HEALTH CARE INSURANCE COMPANY Contract Number: H5820 Organization Marketing Name: UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC. Parent Organization: Universal Health Care Inc. Organization Type: PFFS COMPLIANCE OFFICER Plan Type: PFFS Name: BRUCE R HOFFMAN Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Atlanta Enrollment: 35,633 [email protected] 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 State: FL Zip: Zip: Last Updated: 12/22/2008 Legal Entity Name: UNIVERSAL HEALTH CARE, INC. Contract Number: H5404 Organization Marketing Name: Universal Health Care, Inc. Parent Organization: Universal Health Care Inc. COMPLIANCE OFFICER Name: BRUCE R HOFFMAN Contract Effective Date: 7/1/2003 Phone: CMS Region Responsible: Atlanta Enrollment: 20,540 [email protected] 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 State: FL Zip: Zip: Last Updated: 2/17/2009 Legal Entity Name: UNIVERSAL HEALTH CARE, INC. Contract Number: H5429 Organization Marketing Name: Universal Health Care, Inc. Parent Organization: Universal Health Care Inc. COMPLIANCE OFFICER Name: BRUCE R HOFFMAN Contract Effective Date: 9/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 1,527 [email protected] Address: UNIVERSAL HEALTH CARE, INC. Legal Entity Address: UNIVERSAL HEALTH CARE, INC. 100 CENTRAL AVENUE, SUITE CENTRAL AVENUE, SUITE 200 City: SAINT PETERSBURG City: SAINT PETERSBURG State: FL State: FL Zip: Zip: Last Updated: 2/17/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 181 of 190
182 Legal Entity Name: UNIVERSITY HEALTH CARE, INC. Contract Number: H1807 Organization Marketing Name: Passport Advantage Parent Organization: University Health Care, Inc. Name: PAD Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Atlanta Enrollment: 9,565 Address: 305 West Broadway Legal Entity Address: 305 WEST BROADWAY 3rd Floor THIRD FLOOR City: Louisville City: LOUISVILLE State: KY State: KY Zip: Zip: Last Updated: 8/24/2006 Legal Entity Name: UNIVERSITY OF PITTSBURGH MEDICAL CENTER Contract Number: H3907 Organization Marketing Name: UPMC Health Plan Parent Organization: University of Pittsburgh Medical Center 1/1/2001 CMS Region Responsible: Philadelphia Enrollment: 71,577 Medicare Hotline Name: UPMC Health Plan Phone: Address: 112 Washington Place Contract Effective Date: Legal Entity Address: ONE CHATHAM CENTER 112 WASHINGTON PLACE City: Pittsburgh City: PITTSBURGH State: PA State: PA Zip: Zip: Last Updated: 9/1/2006 Legal Entity Name: UPH/MIHS VENTURES L.L.C. Contract Number: H7352 Organization Marketing Name: University Physicians/Maricopa Care Advantage Parent Organization: UPH/MIHS Ventures, L.L.C. Sales and Marketing Manager Name: April Forman Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: San Francisco Enrollment: 1,280 Address: 2701 E. Elvira Legal Entity Address: 2701 E. Elvira City: Tucson City: Tucson State: AZ State: AZ Zip: Zip: Last Updated: 12/2/2008 Legal Entity Name: UPHAMS CORNER HEALTH COMMITTEE, INC. Contract Number: H2220 Organization Marketing Name: Uphams Corner Health Committee, Inc. Parent Organization: Uphams Corner Health Committee, Inc. Organization Type: National PACE Director of Operations Plan Type: National PACE Name: Jagdeep Trivedi Contract Effective Date: 11/1/2002 Phone: CMS Region Responsible: Boston Enrollment: Address: 1140 Dorchester Ave. Legal Entity Address: 500 Columbia Road Mail Stop City: Dorchester City: DORCHESTER State: MA State: MA Zip: Zip: Last Updated: 4/16/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 182 of 190
183 Legal Entity Name: UPMC HEALTH BENEFITS, INC. Contract Number: H1254 Organization Marketing Name: UPMC Health Plan Parent Organization: University of Pittsburgh Medical Center Organization Type: PFFS Plan Type: PFFS Medicare Hotline Name: UPMC Health Plan Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Philadelphia Enrollment: 7,795 Address: 112 Washington Place Legal Entity Address: One Chatham Center 112 Washington Place City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 8/18/2006 Legal Entity Name: UPMC HEALTH BENEFITS, INC. Contract Number: H9670 Organization Marketing Name: UPMC Health Plan Parent Organization: University of Pittsburgh Medical Center 1/1/2009 CMS Region Responsible: Philadelphia Enrollment: * Medicare Hotline Name: UPMC Health Plan Phone: [email protected] Address: 112 Washington Place Contract Effective Date: Legal Entity Address: 112 Washington Place City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 12/21/2007 Legal Entity Name: UPMC HEALTH NETWORK Contract Number: H5533 Organization Marketing Name: UPMC Health Plan Parent Organization: University of Pittsburgh Medical Center Medicare Hotline Name: UPMC Health Plan Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Philadelphia Enrollment: 1,723 [email protected] Address: 112 Washington Place Legal Entity Address: 112 Washington Place City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 9/1/2006 Legal Entity Name: UPMC HEALTH PLAN INC. Contract Number: H2169 Organization Marketing Name: UPMC Health Plan Parent Organization: University of Pittsburgh Medical Center Medicare Hotline Name: UPMC Health Plan Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Philadelphia Enrollment: 65 [email protected] Address: 112 Washington Place Legal Entity Address: One Chatham Center 112 Washington Place City: Pittsburgh City: Pittsburgh State: PA State: PA Zip: Zip: Last Updated: 1/31/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 183 of 190
184 Legal Entity Name: VANTAGE HEALTH PLAN, INC. Contract Number: H5576 Organization Marketing Name: Vantage Health Plan, Inc. Parent Organization: Vantage Health Plan, Inc. Director of Compliance Name: Keith McRee Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Dallas Enrollment: 3,628 Address: 130 DeSiard St Legal Entity Address: 130 DeSiard St Suite 300 Suite 300 City: Monroe City: Monroe State: LA State: LA Zip: Zip: Last Updated: 5/25/2008 Legal Entity Name: VIA CHRISTI HEALTHCARE OUTREACH PROGRAM FOR ELDERS Contract Number: H1714 Organization Marketing Name: Via Christi HOPE Parent Organization: Via Christi Outreach Pgrm. Elders, Inc Organization Type: National PACE Plan Type: National PACE 9/1/2002 Center Manager Name: Dan Kearns Phone: Contract Effective Date: CMS Region Responsible: Kansas City Enrollment: Address: 2622 W Central, Suite 101 Legal Entity Address: 2622 W. Central - Suite 101 City: Wichita City: WICHITA State: KS State: KS Zip: Zip: Last Updated: 3/13/2008 Legal Entity Name: VIRGINIA PREMIER HEALTH PLAN, INC. Contract Number: H9882 Organization Marketing Name: Virginia Premier Gold Parent Organization: Virginia Premier Health Plan, Inc. Director, Medicare Programs Name: Jill Sumner Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Philadelphia Enrollment: [email protected] Address: 600 E Broad St Legal Entity Address: 600 EAST BROAD STREET SUITE 400 City: Richmond City: RICHMOND State: VA State: VA Zip: Zip: Last Updated: 6/13/2008 Legal Entity Name: VISTA HEALTHPLAN OF SOUTH FLORIDA, INC. Contract Number: H1013 Organization Marketing Name: Vista Healthplan of South Florida, Inc. Parent Organization: Coventry Health Care Inc. Name: VHP Customer Service Contract Effective Date: 6/1/1987 Phone: CMS Region Responsible: Denver Enrollment: 8,331 [email protected] Address: 1340 Concord Terrace Legal Entity Address: 1340 Concord Terrace City: Sunrise City: Sunrise State: FL State: FL Zip: Zip: Last Updated: 8/18/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 184 of 190
185 Legal Entity Name: VISTA HEALTHPLAN, INC. Contract Number: H1076 Organization Marketing Name: Vista Healthplan, Inc. Parent Organization: Coventry Health Care Inc. Name: VHP Customer Service Contract Effective Date: 1/1/1995 Phone: CMS Region Responsible: Denver Enrollment: 4,317 Address: 1340 Concord Terrace Legal Entity Address: 1340 Concord Terrace City: Sunrise City: Sunrise State: FL State: FL Zip: Zip: Last Updated: 2/4/2009 Legal Entity Name: VIVA HEALTH, INC. Contract Number: H0154 Organization Marketing Name: VIVA Medicare Plus Parent Organization: UAB Health System VIVA Medicare Plus Member Services Name: Member Services Contract Effective Date: 5/1/1998 Phone: CMS Region Responsible: Atlanta Enrollment: 28,050 Address: th Avenue South Legal Entity Address: th Avenue South City: Birmingham City: BIRMINGHAM State: AL State: AL Zip: Zip: Last Updated: 12/12/2007 Legal Entity Name: VNS CHOICE Contract Number: H5549 Organization Marketing Name: VNS CHOICE Medicare Parent Organization: Visiting Nurse Service of New York Director, Compliance and Regulatory Affairs Name: Karl Dehm Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: New York Enrollment: 2,452 Address: 1250 Broadway Legal Entity Address: 107 E 70th Street City: New York 11th Floor City: New York State: NY State: NY Zip: Zip: Last Updated: 6/2/2008 Legal Entity Name: VOLUNTEERS OF AMERICA NATIONAL SERVICES Contract Number: H2815 Organization Marketing Name: Senior CommUnity Care of Colorado Parent Organization: Volunteers of America National Services Organization Type: National PACE Plan Type: National PACE Executive Director Name: Gary Snider Contract Effective Date: 8/1/2008 Phone: CMS Region Responsible: Denver Enrollment: [email protected] Address: 2377 Robins Way Legal Entity Address: 2377 Robins Way City: Montrose City: Montrose State: CO State: CO Zip: Zip: Last Updated: 12/29/2008 June 2009 Contract Directory Sorted by Legal Entity Name Page 185 of 190
186 Legal Entity Name: WABASH MEM. HOSPITAL Contract Number: H6140 Organization Marketing Name: Wabash Mem. Hospital Parent Organization: Wabash Memorial Hospital Association Organization Type: HCPP Cost Plan Type: HCPP Cost Admin. Name: Tamara Bivins Contract Effective Date: 1/1/1987 Phone: CMS Region Responsible: Chicago Enrollment: 1,784 [email protected] Address: 1340 N. Water St Legal Entity Address: 1501 NORTH WATER ST. PO Box 1340 City: Decatur City: DECATUR State: IL State: IL Zip: Zip: Last Updated: 6/2/2008 Legal Entity Name: WELBORN HEALTH PLAN Contract Number: H1558 Organization Marketing Name: Welborn Health Plans Parent Organization: Welborn Clinic Organization Type: 1876 Cost Product Manager Plan Type: 1876 Cost Name: David Marx Contract Effective Date: 11/1/1997 Phone: CMS Region Responsible: Chicago Enrollment: 1,872 [email protected] Address: 101 SE Third St Legal Entity Address: 101 S.E. Third Street City: Evansville City: EVANSVILLE State: IN State: IN Zip: Zip: Last Updated: 4/30/2008 Legal Entity Name: WELL CARE OF FLORIDA, INC. Contract Number: H1032 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2000 Phone: CMS Region Responsible: Atlanta Enrollment: 79,374 [email protected] Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Road City: Tampa City: TAMPA State: FL State: FL Zip: Zip: Last Updated: 1/9/2009 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ARIZONA, INC. Contract Number: H1340 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Organization Type: PFFS Plan Type: PFFS Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Atlanta Enrollment: 58,196 [email protected] Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 2 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 4/13/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 186 of 190
187 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ARIZONA, INC. Contract Number: H2491 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2009 Phone: CMS Region Responsible: Atlanta Enrollment: Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 1 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 1/12/2009 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. Contract Number: H0967 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. 1/1/2008 For Profit CMS Region Responsible: Atlanta Enrollment: 769 Plan Directory Contact Name: Mary Solomon Phone: [email protected] Address: 8735 Henderson Road Contract Effective Date: Tax Status: 3091 Legal Entity Address: 8735 Henderson Rd Ren 1 City: Tampa FL City: Tampa State: FL Zip: Last Updated: State: Zip: 1/13/2009 Legal Entity Name: WELLCARE HEALTH INSURANCE OF ILLINOIS, INC. Contract Number: H4577 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Organization Type: PFFS Plan Type: PFFS Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Atlanta Enrollment: 43,023 [email protected] Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 2 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 4/13/2009 Legal Entity Name: WELLCARE HEALTH INSURANCE OF NEW YORK, INC. Contract Number: H6499 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Organization Type: PFFS Plan Type: PFFS Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2007 Phone: CMS Region Responsible: Atlanta Enrollment: 5,750 [email protected] Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 2 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 4/13/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 187 of 190
188 Legal Entity Name: WELLCARE HEALTH PLANS OF NEW JERSEY, INC. Contract Number: H0913 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary L Solomon Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 2,396 [email protected] Address: 8735 Henderson Road Legal Entity Address: P.O. Box City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 2/12/2009 Legal Entity Name: WELLCARE OF CONNECTICUT, INC. Contract Number: H0712 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. 5/1/2005 CMS Region Responsible: Atlanta Enrollment: 3,889 Director of Regulatory Affairs Name: Mary Solomon Phone: [email protected] Address: WellCare Health Plans 8735 Henderson Road City: Tampa State: FL Zip: Last Updated: Contract Effective Date: Legal Entity Address: 116 WASHINGTON AVENUE City: NORTH HAVEN State: CT Zip: /19/2009 Legal Entity Name: WELLCARE OF GEORGIA, INC. Contract Number: H1112 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 7/1/2005 Phone: CMS Region Responsible: Atlanta Enrollment: 5,780 [email protected] Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 1 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 1/11/2009 Legal Entity Name: WELLCARE OF LOUISIANA, INC. Contract Number: H1903 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 9/1/2004 Phone: CMS Region Responsible: Atlanta Enrollment: 3,969 [email protected] Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 1 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 1/12/2009 June 2009 Contract Directory Sorted by Legal Entity Name Page 188 of 190
189 Legal Entity Name: WELLCARE OF OHIO, INC. Contract Number: H0117 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 1/1/2008 Phone: CMS Region Responsible: Atlanta Enrollment: 2,487 Address: 8735 Henderson Road Legal Entity Address: 8735 Henderson Rd Ren 1 City: Tampa City: Tampa State: FL State: FL Zip: Zip: Last Updated: 5/19/2009 Legal Entity Name: WELLCARE OF TEXAS, INC. Contract Number: H1264 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. 1/1/2008 For Profit CMS Region Responsible: Atlanta Enrollment: 6,592 Plan Directory Contact Name: Mary Solomon Phone: [email protected] Address: 8735 Henderson Road Contract Effective Date: Tax Status: 3091 Legal Entity Address: 8735 Henderson Rd Ren 1 City: Tampa FL City: Tampa State: FL Zip: Last Updated: State: Zip: 1/11/2009 Legal Entity Name: WELLCARE_OF NEW YORK, INC. Contract Number: H3361 Organization Marketing Name: WellCare Parent Organization: WellCare Health Plans, Inc. Plan Directory Contact Name: Mary Solomon Contract Effective Date: 9/1/1995 Phone: CMS Region Responsible: Atlanta Enrollment: 25,407 [email protected] Address: 8735 Henderson Road Legal Entity Address: P.O.BOX 1652 City: Tampa City: NEWBURGH State: FL State: NY Zip: Zip: Last Updated: 1/12/2009 Legal Entity Name: WESTERN HEALTH ADVANTAGE Contract Number: H0532 Organization Marketing Name: Western Health Advantage Parent Organization: Western Health Advantage Name: Member Services Contract Effective Date: 8/1/1999 Phone: CMS Region Responsible: San Francisco Enrollment: 1,177 [email protected] Address: 2349 Gateway Oaks Drive, Suite 100 Legal Entity Address: 2349 GATEWAY OAKS DRIVE, SUITE 100 City: Sacramento City: SACRAMENTO Zip: Zip: Last Updated: 11/9/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 189 of 190
190 Legal Entity Name: WINDSOR HEALTH PLANS, INC. Contract Number: H5698 Organization Marketing Name: Windsor Medicare Extra Parent Organization: Windsor Health Group Name: Member Services Contract Effective Date: 1/1/2006 Phone: CMS Region Responsible: Denver Enrollment: 28,221 Address: 7100 Commerce Way, Ste 285 Legal Entity Address: 7100 Commerce Way, Ste 285 City: Brentwood City: Brentwood State: TN State: TN Zip: Zip: Last Updated: 11/1/2007 June 2009 Contract Directory Sorted by Legal Entity Name Page 190 of 190
WWW.IMMIGRANTJUSTICE.ORG/KIDS
On the following pages you will find addresses for: Dept. of Justice Immigration Courts AND Dept. of Homeland Security Offices of Chief Counsel (OCC) DISCLAIMER: The most current addresses for DOJ Immigration
How to Change Your Address with the Immigration Court and Government Attorneys
How to Change Your Address with the Immigration Court and Government Attorneys In this guide, we will review step-by-step how to prepare the forms you need to change your address with the Immigration Court
90-400 APPENDIX B. STATE AGENCY ADDRESSES FOR INTERSTATE UIB CLAIMS
INTERSTATE UIB CLAIMS Alabama Multi- Unit (#01) Industrial Relations Bldg. Montgomery, AL 31604 Alaska Interstate Unit (#02) P.O. Box 3-7000 Juneau, AK 99801 Arizona Interstate Liable Office (#03) Department
Alabama Commission of Higher Education P. O. Box 302000 Montgomery, AL. Alabama
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Alabama Commission of Higher Education P. O. Box 302000 Montgomery, AL 36130-2000 (334) 242-1998 Fax: (334) 242-0268 Alaska Commission
Number of Liver Transplants Performed 2003-2004 Updated October 2005
PEDIATRIC CENTERS PEDIATRIC TRANSPLANT CENTERS Number of Liver Transplants Performed 2003-2004 Updated October 2005 University of Alabama Hospital, Birmingham, AL 3 2 1 University Medical Center, University
National Bureau for Academic Accreditation And Education Quality Assurance PUBLIC HEALTH
1 GEORGE WASHINGTON UNIVERSITY WASHINGTON DC B Athletic Training 1 MA B 1 BROWN UNIVERSITY PROVIDENCE RI B EAST TENNESSEE STATE UNIVERSITY JOHNSON CITY TN B 3 HUNTER COLLEGE NEW YORK NY B 4 UNIVERSITY
Plan Directory for Medicare Advantage, Cost, PACE, and Demonstration Organizations. Sorted by Contract Number
Plan Directory for Medicare Advantage, Cost, PACE, and Demonstration Organizations Sorted by Contract Number CPC/MDBG/DPD July 2009 IMPORTANT NOTES 1. This directory contains information for Medicare Advantage,
State Insurance Information
State Insurance Information Alabama 201 Monroe St. Suite 1700 Montgomery, AL 36104 334-269-3550 fax:334-241-4192 http://www.aldoi.org/ Alaska Dept. of Commerce, Division of Insurance. P.O. Box 110805 Juneau,
US Department of Health and Human Services Exclusion Program. Thomas Sowinski Special Agent in Charge/ Reviewing Official
US Department of Health and Human Services Exclusion Program Thomas Sowinski Special Agent in Charge/ Reviewing Official Overview Authority to exclude individuals and entities from Federal Health Care
Alabama Department of Postsecondary Education Private School Licensure Division P.O. Box 302130 Montgomery, AL 36130 2130
Alabama Department of Postsecondary Education Private School Licensure Division P.O. Box 302130 Montgomery, AL 36130 2130 Alaska Commission on Postsecondary Education P.O. Box 110505 Juneau, AK 99811 0505
Property and Casualty Insurance Guaranty Associations Affected by Freestone Ins Co Insolvency. Name Address 1 Address 2 City State Zip Code Tel Number
Property and s Affected by Freestone Ins Co Insolvency Name Address 1 Address 2 City State Zip Code Tel Number Alabama Insurance Suite 200 2020 Canyon Rd Birmingham AL 35216 (205) 823-4042 Arizona Property
Rates are valid through March 31, 2014.
The data in this chart was compiled from the physician fee schedule information posted on the CMS website as of January 2014. CPT codes and descriptions are copyright 2012 American Medical Association.
Online Labor Demand Shows Strong Increases, up 217,900 in December
News Release Follow The Conference Board For further information: Peter Tulupman 212-339-0231 / [email protected] Release #5640 Jonathan Liu 212-339-0257 / [email protected]
Centers of Excellence
Centers of Excellence A program of the NMSDC to enhance corporate minority supplier development through knowledge sharing and excellence in implementing NMSDC best practices. Centers of Excellence enhances
Department of Banking and Finance
Criminal History Reference Listings The following contacts may assist in obtaining criminal history checks from various state agencies. While the information is believed to be reliable, the links reflect
NCQA's Health Insurance Plan Rankings 2010-11 Medicare Plans October 18, 2010
1 Capital Health Plan HMO 89 Yes FL http://www.capitalhealth.com 2 Kaiser Foundation Health Plan of Colorado HMO 88.9 Yes CO http://www.kp.org 3 Fallon Community Health Plan HMO 88.9 Yes MA http://www.fchp.org
State-by-State Listing of Departments of Insurance Updated August 2005
BUREAUS State-by-State Listing of Departments of Insurance Updated August 2005 Alabama Dept. of Insurance P.O. Box 303351 201 Monroe St. #1700 Montgomery AL 36104 (334) 269-3550 http://www.aldoi.org E-mail:
TABLE 37. Higher education R&D expenditures at institutions with a medical school, by state, institutional control, and institution: FY 2011
TABLE 37. Higher education R&D at institutions with a medical school, by state, institutional Alabama U. AL, Birmingham 503,698 369,116 U. South AL 42,233 16,810 Arizona U. AZ 610,565 160,136 Arkansas
Atlanta Rankings 2014
Atlanta Rankings Major National Magazine and Study Rankings BUSINESS FACILITIES Metro Business Rankings Lowest Cost of Doing Business 2. Orlando, FL 3. Charlotte, NC 4. San Antonio, TX 5. Tampa, FL 6.
Grantee City State Award. Maricopa County Phoenix AZ $749,999. Colorado Youth Matter Denver CO $749,900
OAH TEEN PREGNANCY PREVENTION PROGRAM GRANTS July 2015 Capacity Building to Support Replication of Evidence-Based TPP Programs (Tier 1A) Grantee City State Award Maricopa County Phoenix AZ $749,999 Colorado
AZ State Board of Physical Therapy, 1400 W Washington, Suite 230, Phoenix, AZ 85007, Phone: 520-542-3095 Fax: 520-542-3093
General Information Licensing requirements vary state by state. This page will provide you links to each State Licensing Board, along with contact information; and, as we develop it. Please refer to each
List of low tuition universities in the USA. 1. Louisiana Tech University, LA Total Cost to. International Students: $17,472
A list of top universities in the US with low tuition fees for international students. So please find below a comprehensive list of low tuition universities in the US with their respective tuition fees.
ISSUE BRIEF. Health Insurance Marketplace Premiums for 2014
ASPE ISSUE BRIEF Health Insurance Marketplace Premiums for 2014 On October 1, 2013, a Health Insurance Marketplace will open in each state, providing a new, simplified way to compare individual market
NURSING STATE REGULATORY AUTHORITIES Contact the National Council of State Boards of Nursing at https://www.ncsbn.org
ALABAMA RSA Plaza, Suite 250 770 Washington Avenue Montgomery, AL 36104 (334) 242-4060 or 800-656-5318 http://www.abn.state.al.us/ ALASKA 550 West 7th Avenue, Suite 1500 Anchorage, AK 99501-3567 (907)
State Vocational Rehabilitation (VR) Agencies
State Vocational Rehabilitation (VR) Agencies State Vocational Rehabilitation (VR) agencies furnish a wide variety of services to help people with disabilities return to work. These services are designed
Lodging, Rental Car and Meal Taxes on Travelers in the Top 50 U.S. Cities
Lodging, Rental Car and Meal Taxes on Travelers in the Top 50 U.S. Cities July 2008 Prepared by: American Economics Group, Inc. TABLE OF CONTENTS EXECUTIVE SUMMARY...3 TABLES: COMBINED TAXES ON LODGING,
Issuers Owing Rebates for 2012 Data as of August 1, 2013 Rebates in the Individual Market
AK Premera Blue Cross $709,464 Time Insurance Company $227,600 Trustmark Life Insurance Company $645,743 UnitedHealthcare Insurance Company $62,894 AL The MEGA Life and Health Insurance Company $62,541
List of Allocation Recipients
List of Allocation Recipients 4 2012 New Markets Tax Credit Program: List of Allocatees Name of Allocatee Advantage Capital Community Development Fund, LLC New Orleans, LA National $75,000,000 Operating
Issuers Owing Refunds for 2013
Issuers Owing Refunds for 2013 Based on MLR reports filed through June 30, 2014 State AK Premera Blue Cross $2,626,786 $0 $0 The MEGA Life and Health Insurance Company $39,115 $0 $0 Time Insurance Company
Post-Secondary Schools Offering Undergraduate Programs Including Arabic Language/Literature. University name Location Degree offered
Post-Secondary Schools Offering Undergraduate Programs Including Arabic Language/Literature University name Location Degree offered Abilene Christian University Abilene, TX None (Special Dialektos Program)
University of Saint Joseph College of Pharmacy
State School code Name of School AL 001 Auburn University AL 002 Samford University AR 004 University of Arkansas AR 096 Harding University AZ 003 University of Arizona AZ 082 Midwestern University-Glendale
ANTI FRAUD BUREAUS ALASKA ARKANSAS ARIZONA CALIFORNIA
ANTI FRAUD BUREAUS Anti-Fraud Bureaus are generally state operated agencies that have been organized to detect, investigate and deter insurance frauds of many types. Fraud bureaus and insurance company
Issuers Owing Rebates for 2012
AK Premera Blue Cross $709,464 Time Insurance Company $227,600 Trustmark Life Insurance Company $645,743 UnitedHealthcare Insurance Company $62,894 AL The MEGA Life and Health Insurance Company $62,541
ENS Governmental Format Status (As of 06/16/2008)
Alaska AK Production (G) Region D Tan - Development Required Alabama AL Production (G) Region C Arkansas AR Production (G) Region C D Yellow - Pended for required Beta Site Green - In Production - Direct
CPT Codes For Spirometry
Micro Direct, Inc. 803 Webster Street Lewiston, ME 04240 (800) 588-3381 (207) 786-7280 FAX www.mdspiro.com CPT Codes For Spirometry The current Procedural Teminology (CPT) codes defined below are the most
National Bureau for Academic Accreditation And Education Quality Assurance LINGUISTICS # UNIVERSITY CITY STATE DEGREE MAJOR SPECIALTY RESTRICTION
1 UNIVERSITY OF MASSACHUSETTS - BOSTON ~ BOSTON MA M 1 ARIZONA STATE UNIVERSITY - TEMPE TEMPE AZ MD ~ M for Linguistics is for Residential Program ONLY. The online option is not ~ M in Linguistics is for
APPENDIX 1: SURVEY. Copyright 2010 Major, Lindsey & Africa, LLC. All rights reserved.
APPENDIX 1: SURVEY Major, Lindsey & Africa Partner Compensation Survey (2010) Dear : Major, Lindsey & Africa invites you to participate in our 2010 MLA Partner Compensation Survey. This Survey, which is
National Bureau for Academic Accreditation And Education Quality Assurance
1 ARKANSAS STATE UNIVERSITY - STATE UNIV. AR M JONESBORO 2 AUBURN UNIVERSITY - AUBURN AUBURN AL MD 3 BALL STATE UNIVERSITY MUNCIE IN M 4 CALIFORNIA STATE UNIVERSITY - ^ Enrollment to the ESL program and
Department of Veterans Affairs Quarterly Notice to Congress on Data Breaches Third Quarter of Fiscal Year 2015 April 1, 2015 through June 30, 2015
VHA 4/1/15 VISN 01 Boston, MA 1 0 4/15/15 VISN 01 Boston, MA 1 0 4/22/15 VISN 01 Boston, MA 10 0 4/24/15 VISN 01 Boston, MA 1 0 4/27/15 VISN 01 Boston, MA 0 1 4/29/15 VISN 01 Boston, MA 0 1 4/30/15 VISN
Claims Administrators Information for Lockheed Martin Corporation retirees
Claims Administrators Information for Lockheed Martin Corporation retirees This notice constitutes a Summary of Material Modifications (SMM) and provides you with the names, addresses, member services
ANGELOUECONOMICS 2012 INDUSTRY HOTSPOTS
ANGELOUECONOMICS 2012 INDUSTRY HOTSPOTS INDUSTRY SPECIALIZATION OF AMERICA'S 100 LARGEST METROPOLITAN AREAS INDUSTRY CLUSTERS 19-24 (of 36) ABOUT THE RANKINGS In the 21 st Century, the engines that drive
Physical Therapy Marketing Success :: physical therapy assistant schools usa
Physical Therapy Marketing Success :: physical therapy assistant schools usa Physical Therapy Marketing Success :: physical therapy assistant schools usa Downloading From Original Website --> http://f-ebook.esy.es/ptsuccess/pdx/fph1
USA IN-PERSON VOTING OPPORTUNITIES 2010 SWEDISH ELECTION
USA IN-PERSON VOTING OPPORTUNITIES 2010 SWEDISH ELECTION Anchorage, konsulat Wells Fargo Bank, 301 301 W. Northern Lights Blvd, 5th floor Anchorage, AK 99503 Telefon: +1 907 265 2926 Fax: +1 907 265 2068
GROWTH Who We Educate
WHO WE ARE (www.artinstitutes.edu), a system of more than 50 schools located throughout North America, provides an important source for design, media arts, fashion and culinary professionals. Several institutions
The Most Affordable Cities For Individuals to Buy Health Insurance
The Most Affordable Cities For Individuals to Buy Health Insurance Focusing on Health Insurance Solutions for Millions of Americans Copyright 2005, ehealthinsurance. All rights reserved. Introduction:
VOLUNTEER LAWYERS FOR THE ARTS NATIONAL LISTING OF VLA S, INCLUDING CANADA
VOLUNTEER LAWYERS FOR THE ARTS NATIONAL LISTING OF VLA S, INCLUDING CANADA Alabama Alabama VLAA 4320 Eagle Point View Birmingham, AL 35242 Contact: Marcus L. Hunt Phone: 205-408-3025 Email: [email protected]
An issuer must submit at least one QIS to a Marketplace for the 2017 coverage year if the following participation criteria are met:
Qualified Health Plan (QHP) Issuers Expected to Submit a Quality Improvement Strategy (QIS) During the 2017 QHP Application Submission and Review Period Background An issuer participating in a Marketplace
NAAB-Accredited Architecture Programs in the United States
NAAB-Accredited Architecture Programs in the United States ALABAMA Auburn University College of Architecture, Design & Construction Auburn University, AL www.cadc.auburn.edu/soa/ Tuskegee University College
CONTACT INFORMATION FOR STUDENT COMPLAINT PROCESSES *
Alabama Alaska Alabama Commission on Higher Education PO Box 302000 Montgomery, AL 36130-2000 http://www.accs.cc/complaintform.aspx Alaska Commission on Postsecondary Education PO Box 110505 Juneau, AK
STATE INCOME TAX WITHHOLDING INFORMATION DOCUMENT
STATE INCOME TAX WITHHOLDING INFORMATION DOCUMENT Zurich American Life Insurance Company (ZALICO) Administrative Offices: PO BOX 19097 Greenville, SC 29602-9097 800/449-0523 This document is intended to
How To Know The Nursing Workforce
FAST FACTS The Nursing Workforce 2014: Growth, Salaries, Education, Demographics & Trends RN Job Growth Rate (new and replacement) By State/Region, 2012-2022) 14 states project an annual growth rate of
University of Alabama School of Medicine
University of Alabama School of 0 Match Results by PGY Residency Location Akron City Hospital Akron, OH Transitional Akron City Hospital Akron, OH Akron General Medical Akron, OH Akron General Medical
Masters of Science in Finance Online Degree Program Updated February 5, 2014.
Masters of Science in Finance Online Degree Program Updated February 5, 2014. This document contains the following information related to Georgetown University s Master of Science in Finance Online Program:
INDEX ANNOUNCEMENT. July Rebalancing Results for S&P National AMT-Free Municipal Bond Index Announced by S&P Dow Jones Indices
INDEX ANNOUNCEMENT July Rebalancing Results for S&P National AMT-Free Municipal Bond Index Announced by S&P Dow Jones Indices New York, NY, June 27, 2016 S&P Dow Jones Indices announced today the results
claims reporting guide and office directory Delivering unparalleled results
claims reporting guide and office directory Delivering unparalleled results Zurich North America Table of Contents Zurich North America Claims Model Technological Features of the Claims Model How to Report
Naming. Registered Agent
Naming Registered Agent Listing the correct name and address of your Registered Agent on filings is critically important. To make sure you have the most current address for NCR in a given state, always
ANTHONY P. CARNEVALE NICOLE SMITH JEFF STROHL
State-Level Analysis HELP WANTED PROJECTIONS of JOBS and EDUCATION REQUIREMENTS Through 2018 JUNE 2010 ANTHONY P. CARNEVALE NICOLE SMITH JEFF STROHL Contents 1 Introduction 3 U.S. Maps: Educational concentrations
2016 Individual Exchange Premiums updated November 4, 2015
2016 Individual Exchange Premiums updated November 4, 2015 Within the document, you'll find insights across 50 states and DC with available findings (i.e., carrier participation, price leadership, gross
Small Employer Market Stand-Alone Dental Plans in Virginia 2015
Small Employer Market Stand-Alone Dental Plans in Virginia 2015 General Information: The Bureau of Insurance has identified the companies on the attached list as having had one or more stand-alone dental
Physical Therapy Marketing Success :: physical therapy assistant schools usa
Physical Therapy Marketing Success :: physical therapy assistant schools usa Physical Therapy Marketing Success :: physical therapy assistant schools usa Downloading From Original Website --> http://f-ebook.esy.es/ptsuccess/pdx/fph1
Distributors. United States. Arizona. quick list Arizona, California, Colorado, Connecticut, Delaware, District of
Distributors United States quick list Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho*, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts,
DAYTONA COLLEGE STATE AGENCIES
2013 DAYTONA COLLEGE STATE AGENCIES 2012-2013 Revised August 2012 State Agencies If a student s complaint cannot be resolved after exhausting the Institution s grievance procedure (published in the College
The New Analytical Mindset For Finance and Accounting Professionals
The New Analytical Mindset For Finance and Accounting Professionals 10/18/2016 9:00 AM - 11:00 AM The New Analytical Mindset For Finance and Accounting Professionals 10/20/2016 9:00 AM - 11:00 AM The New
Vocational Rehabilitation Funding for a Power Wheelchair with ilevel:
Vocational Rehabilitation Funding for a Power Wheelchair with ilevel: The American s with Disabilities Act (ADA) was signed into law on July 26, 1990. It is a wide-ranging law intended to make American
National Bureau for Academic Accreditation And Education Quality Assurance
1 ARIZONA STATE UNIVERSITY - TEMPE TEMPE AZ MD 2 BOSTON COLLEGE CHESTNUT HILL MA B 3 BOSTON UNIVERSITY ^ BOSTON MA B 4 CASE WESTERN RESERVE UNIVERSITY CLEVELAND OH B ^ D in Music is for Residential Program
Agencies for Higher Education in the U.S.A.
Agencies for Higher Education in the U.S.A. The following agencies are those that license, regulate, or are otherwise concerned with higher education in their state. The contact information changes on
STATE CONSUMER ASSISTANCE PROGRAMS UNDER PHS ACT SECTION 2793
STATE CONSUMER ASSISTANCE PROGRAMS UNDER PHS ACT SECTION 2793 Alabama (No program) Alaska (No program) Arizona (No program) Arkansas Arkansas Insurance Department Consumer Services Division 1200 West Third
United States Bankruptcy Court District of Arizona NOTICE TO: DEBTOR ATTORNEYS, BANKRUPTCY PETITION PREPARERS AND DEBTORS
United States Bankruptcy Court District of Arizona NOTICE TO: DEBTOR ATTORNEYS, BANKRUPTCY PETITION PREPARERS AND DEBTORS UPDATED REQUIREMENTS FOR FORMAT OF MASTER MAILING LIST The meeting of creditors
The MetLife Market Survey of Assisted Living Costs
The MetLife Market Survey of Assisted Living Costs October 2005 MetLife Mature Market Institute The MetLife Mature Market Institute is the company s information and policy resource center on issues related
COMMERCIAL FINANCE ASSOCIATION. Annual Asset-Based Lending and Factoring Surveys, 2008
COMMERCIAL FINANCE ASSOCIATION Annual Asset-Based Lending and Factoring Surveys, 2008 Non-Member Edition May 6, 2009 R.S. Carmichael & Co., Inc. Commercial Finance Association 70 West Red Oak Lane (4 th
Registration Number. Category. Credit Counseling. Non Profit. Credit. Counseling, Non Profit. Credit. Profit. Credit. Counseling and Debt Settlement
Business/ Trade Name Address Registration Number Category Original Registration Date Cancel/Revoke Date Disciplinary Action Advantage Counseling Service, Inc. 2403 Sidney Street Pittsburgh, PA 15203 13
CONTACT INFORMATION FOR STUDENT COMPLAINT PROCESSES *
CONTACT INFORMATION FOR STUDENT COMPLAINT PROCESSES * ALABAMA Alabama Commission on Higher Education P. O. Box 302000 Montgomery, AL 36130-2000 http://www.accs.cc/complaintform.aspx ALASKA Alaska Commission
CONTACT INFORMATION FOR STUDENT COMPLAINT PROCESSES*
- CONTACT INFORMATION FOR STUDENT COMPLAINT PROCESSES* ARIZONA Arizona State Board for Private Postsecondary Education 1400 W. Washington Street Room 260 Phoenix, AZ 85007 http://azppse.state.az.us/student_info/compliance.asp
Ethernet Access (Formerly Converged Ethernet Access) Operations Manual
Ethernet Access (Formerly Converged Ethernet Access) Operations Manual 1. Service Description. Ethernet Access (formerly known as Converged Ethernet Access or Multi-Service Ethernet Access) provides dedicated
Table 1: Advertising, Marketing and Promotional Expense as a Percentage of Net Operating Revenue
Table 1: Advertising, Marketing and Promotional Expense as a Percentage of Net Operating Revenue NAIC Group % Attorney s Title 3.8% Chicago / Fidelity 0.9% Diversified 0.6% First American 2.7% Investors
United States Bankruptcy Court District of Arizona
United States Bankruptcy Court District of Arizona NOTICE TO: DEBTOR ATTORNEYS, BANKRUPTCY PETITION PREPARERS AND DEBTORS UPDATED REQUIREMENTS FOR FORMAT OF MASTER MAILING LIST The meeting of creditors
U.S. Call Centers National Problem Gambling Helpline (800-522-4700) Updated as of February 2014
U.S. Call Centers National Problem Gambling Helpline (800-522-4700) Updated as of February 2014 States Answered for National Network AK, AR, DC, HI, ID, LA, NH, NV, PA, PR, TX, UT, VA, WA, WY, USVI, MD(nights/weekends)
Braceros Class Action Settlement CLAIM FORM INFORMATION
OVERVIEW: The Mexican Farm Labor Program (popularly known as the bracero program) was a temporary contract labor program initiated by an exchange of diplomatic notes between the USA and Mexico. Braceros
LexisNexis Law Firm Billable Hours Survey Top Line Report. June 11, 2012
LexisNexis Law Firm Billable Hours Survey Top Line Report June 11, 2012 Executive Summary by Law Firm Size According to the survey, we found that attorneys were not billing all the time they worked. There
HEALTH & WELFARE FUNDS SIGNATORY TO THE NATIONAL RECIPROCAL AGREEMENT
NATIONAL FUNDS 05/18/2010 1 Laborers' National Health & Welfare Fund Suite 210, 5565 Sterrett Place, Columbia, MD 21044 Phone: 1-800-235-5805 Fax: 410-997-3657 EASTERN 05/18/2010 2 Local 472 and 172 Trust
650-488-8565 San Mateo, CA 94403 Advance Insurance Agency, Inc. 5241 Viking Drive
ABD Insurance & Financial Services, 3 Waters Park Drive #100 650-488-8565 Inc San Mateo, CA 94403 Advance Insurance Agency, Inc. 5241 Viking Drive 952.831.1928 Edina, MN 55435 AHT Insurance 600 University
Office Space FOR LEASE. Humber Green Medical Centre Toronto. 100 Humber College Blvd. Toronto, Ontario M9V 5G4. For more information, please contact:
Humber Green Medical Centre Toronto Office Space FOR LEASE 100 Humber College Blvd. Toronto, Ontario M9V 5G4 For more information, please contact: Binswanger Hectare, Brokerage 1279 Matheson Boulevard
Brandi Dougherty Compliance Manager Allied Business Schools, Inc. 22952 Alcalde Drive Laguna Hills, CA 92653-1311 bdougherty@allied.
Complaint Procedure From time to time, differences in interpretation of school policies will arise among students, faculty, and/or the administration. When such differences arise, usually a miscommunication
A B C D E. Boston MA NA Environmental Health (MPH; PhD) Environmental/Occupational Health and Safety (BS) Environmental & Occupational Health (BS);
2 3 4 5 6 7 8 9 0 2 3 4 5 6 7 8 9 20 Alabama A&M University Norman AL Environmental Science (BS) Benedict College Columbia SC Environmental (BS) Bloomsburg University PA Physics (BS) Boise State University
State Charitable Registration
State Charitable Registration Alabama: AL08-183 Alabama Office of the Attorney General Consumer Affairs Division 11 S. Union St., Montgomery, Alabama 36130 Alaska: TID# 042433182 Alaska Department of Law
FACT SHEET. Language Assistance to Persons with Limited English Proficiency (LEP).
FACT SHEET Office of Civil Rights Washington, D.C. 20201 (202) 619-0403 Language Assistance to Persons with Limited English Proficiency (LEP). To ensure that persons with limited English skills can effectively
Advantage Workers Compensation Insurance Company 10/21/14 Client ID 001662 Gallagher Bassett Claim Offices
ALABAMA Gallagher Bassett Services - 113 601 Vestavia Pkwy., Suite 251 Birmingham, AL 35216 Phone: 205-822-4220 Fax: 205-822-8175 Toll Free #: 800-762-3486 Branch Manager: Jim Colli Ph# 615-932-6492 ALASKA
U.S. NEWS RANKING OF MEDICAL COLLEGES 2012
U.S. NEWS RANKING OF MEDICAL COLLEGES 2012 http://grad schools.usnews.rankingsandreviews.com/best graduate schools/top medicalschools/research rankings Best Medical Schools: Research To see full rankings,
How To Get A Transcript From A Closed School
OTHER STATE S CLOSED SCHOOL TRANSCRIPT HOLDERS AK: AL: AR: AZ: CA: CO: CT: Alaska Commission on Postsecondary Education P.O. Box 110505 Juneau, AK 99811 0505 Linda Polk, Records Officer (907) 465 6698
Physical Therapy Marketing Success :: physical therapy assistant schools usa
Physical Therapy Marketing Success :: physical therapy assistant schools usa Physical Therapy Marketing Success :: physical therapy assistant schools usa Downloading From Original Website --> http://f-ebook.esy.es/ptsuccess/pdx/fph1
How To Get A Life Insurance Policy For 2010
This is a listing of Insurers who offer Medicare Supplement Plans for purchase in Pennsylvania. The reference to "group" on this list indicates that the product is available only on a group basis. This
BEST INDIVIDUAL LIFE INSURANCE MARKETS
IAP ANALYTICS: BEST INDIVIDUAL LIFE INSURANCE MARKETS A ZIP code through national level look at where today s most likely buyers are June 2015 Information Asset Partners 732 662 1859 [email protected]
The MetLife Market Survey of Nursing Home & Home Care Costs
The MetLife Market Survey of Nursing Home & Home Care Costs September 2005 MetLife Mature Market Institute The MetLife Mature Market Institute is the company s information and policy resource center on
2010 Utility Bill Comparisons for Selected U.S. Cities
Memphis Light, Gas and Water 2010 Utility Bill Comparisons for Selected U.S. Cities Electricity Natural Gas Water Wastewater The information in this book has been compiled to ensure maximum accuracy at
Health Insurance Exchanges and the Medicaid Expansion After the Supreme Court Decision: State Actions and Key Implementation Issues
Health Insurance Exchanges and the Medicaid Expansion After the Supreme Court Decision: State Actions and Key Implementation Issues Sara R. Collins, Ph.D. Vice President, Affordable Health Insurance The
