Sunshine State Health Plan, Inc. D/B/A Wellcare- DSNP

This Master Agreement establishes a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) that provides coordinated and integrated healthcare services to beneficiaries eligible for both Medicare and Medicaid in Florida. Under this vehicle, the prime contractor delivers comprehensive medical and support services including Medicare Part A, Part B, and Part D benefits aligned with Medicaid services through a Highly Integrated Dual Eligible (HIDE) SNP structure. The scope of covered services encompasses primary care, acute care, behavioral health services, home health services, long-term support and services, durable medical equipment, emergency services, prescription drugs, clinic services, and specialized medical services as defined in Florida Medicaid policies and federal regulations. The plan operates across nine authorized service regions (Regions A through I) throughout Florida and serves multiple eligibility categories including Fully Benefit Dual Eligible (FBDE), Qualified Medicare Beneficiary (QMB), QMB Plus, Specified Low-Income Medicare Beneficiary Plus (SLMB Plus), and other cost-sharing assistance populations.

Sunshine State Health Plan Inc., operating as WellCare, serves as the prime contractor for this agreement with the Florida Agency for Health Care Administration. The contract is effective January 1, 2026, through December 31, 2028, with provisions for renewal for up to three additional years contingent upon satisfactory performance and fund availability. The total contract amount is not to exceed $41,589,230.78, with a required performance bond of $4,158,923.08. The contracting arrangement is structured as a capitated managed care contract covering the entire state of Florida, and the contractor must comply with comprehensive federal and state procurement requirements, performance monitoring obligations, and background screening protocols for employees with access to protected health information.