Care Improvement Plus South Central Insurance Company- DSNP

This Master Agreement establishes a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) that provides coordinated and integrated Medicare and Medicaid services to dual-eligible beneficiaries throughout Florida. The plan delivers comprehensive coverage including Medicare Part A, Part B, and Part D benefits along with Medicaid-covered services such as behavioral health services, long-term support and services, home health services, and medical supplies and equipment. The D-SNP operates as a Fully Integrated Dual Eligible (FIDE) Special Needs Plan serving nine authorized service regions across all 67 Florida counties, with coverage extended to qualified populations including Qualified Medicare Beneficiaries (QMB), QMB Plus, Specified Low-Income Medicare Beneficiaries (SLMB), SLMB Plus, Qualifying Individuals (QI), and Full Benefit Dual Eligible (FBDE) individuals. The plan includes mandatory care coordination, case management, transition of care planning, and compliance with Early and Periodic Screening, Diagnosis and Treatment (EPSDT) requirements for enrollees under twenty-one years of age.

Care Improvement Plus South-Central Insurance Company (operating as UnitedHealthcare) serves as the prime contractor under this Master Agreement, with the Agency for Health Care Administration functioning as the contracting organization. The contract period extends from January 1, 2026, through December 31, 2028, with renewal options available for up to three additional years contingent upon satisfactory performance and legislative appropriation. The total contract value does not exceed $3,653,097.44, with a required performance bond of $365,309.74. This Master Agreement covers the state of Florida and is structured as a capitated, fully integrated managed care arrangement requiring the contractor to maintain accredited provider networks, provide multilingual services, and comply with all applicable state and federal Medicaid and Medicare regulations.