A Medicare Advantage Dual Eligible Special Needs Plan (D-SNP

This Master Agreement establishes a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) designed to provide coordinated care services to dual-eligible beneficiaries—individuals eligible for both Medicare and Medicaid—throughout Florida. The contract authorizes the delivery of comprehensive integrated healthcare services across nine authorized service regions (Regions A through I), encompassing multiple Florida counties including Orange, Hillsborough, Broward, Miami-Dade, and Palm Beach, among others. Services provided under this IDV include coordinated Medicare and Medicaid benefits, behavioral health services, long-term care, home health services, durable medical equipment, emergency services, pharmacy benefits, care coordination, discharge planning, and clinical services as specified in Florida Medicaid policies. The plan serves qualified beneficiary categories including QMB, QMB Plus, SLMB, SLMB Plus, FBDE, QDWI, and QI populations through multiple Plan Benefit Packages offered across the authorized service regions.

HealthSpring of Florida, Inc., a subsidiary of Cigna Healthcare, serves as the prime contractor under this Master Agreement with the Agency for Health Care Administration (AHCA), the contracting organization for the State of Florida. The contract period of performance extends from January 1, 2026, through December 31, 2028, with optional renewal periods not exceeding three years subject to satisfactory performance and fund availability. The contract is structured as a Master Agreement with a total compensation amount not to exceed $18,324,119.10, contingent upon legislative appropriations and fund availability, with specific Medicaid capitated rates for each region and eligibility category to be determined and approved by the Centers for Medicare & Medicaid Services (CMS). HealthSpring must furnish a performance bond of $1,832,411.91 and maintain full compliance with all applicable federal and state regulations, including HIPAA, HITECH, background screening requirements, and comprehensive reporting and audit compliance protocols.